高プロラクチン(PRL)血症を伴う下垂体腺腫の治療成績

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1 . We studied serum PRL abnormalities in patients with various disorders of hypothalamo-hypophyseal system.When the basal serum PRL level was above 300 ng/ml, the presence of pituitary adenoma was strongly suggested.2. Of 16 pituitary adenomas with hyperprolactinemia, 9 were associated with acromegaly (6 males, 3 females) and 7 with Forbes-Albright syndrome (amenorrhea-galactorrhea syndrome). Galactorrhea was also found in 6 of these 9 acromegalic patients, interestingly 3 of them were male cases. Amenorrhea was seen in all female cases with hyperprolactinemia except for one acromegalic case.3. Serum PRL levels ranged from 46.2 to 508.2 ng/ml (mean:203.2 ng/ml) in acromegalic patients and from 222.0 to 2100.0 ng/ml (mean : 1289.9 ng/ml) in patients with Forbes-Albright syndrome. Thus, the latter showed significantly higher levels of serum PRL.4. Acromegalic patients showed more than 50% increment of serum PRL to TRH infusion, whereas, alrnost all patients with Forbes-Albright syndrome did less than 50%. Intratumoral hemorrhage was found in 4 patients with Forbes-Albright syndrome by surgery. Two of them had episodes of pituitary apoplexy preoperatively.6. It should be emphasized that early diagnosis and treatment is essential to normalize the dysfunction of hypothalamo-hypophyseo-gonadal axis. We consider that in patients with Forbes-Albright syndrome, visual dis-turbances and galactorrhea could be cured in almost all patients and ovarian dysfunction could also be normalized about more than half by transsphenoidal surgery combined with CB-154 and/or irradiation.
日本脳神経外科学会の論文

高プロラクチン(PRL)血症を伴う下垂体腺腫の治療成績

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