Материалы доступны только для специалистов сферы здравоохранения. Авторизуйтесь или зарегистрируйтесь.
Эффективность агонистов дофамина в контроле биохимических маркеров пролактинсекретирующей аденомы гипофиза (клинический случай)
Материалы доступны только для специалистов сферы здравоохранения. Авторизуйтесь или зарегистрируйтесь.
Аннотация
Гиперпролактинемия – тяжелое нейроэндокринное заболевание, вызываемое избыточной продукцией гормона пролактина (Прл) аденогипофизом. Пролактиномы – наиболее распространенные опухоли гипоталамо-гипофизарной системы, составляющие до 40% всех новообразований гипофиза. У мужчин встречаемость пролактином составляет 0,4–30%, что гораздо реже, чем у женщин. Клинические проявления заболевания у мужчин довольно скудны, чаще проявляются снижением интереса к половой жизни, эректильной дисфункцией, бесплодием. На протяжении многих лет опухоль может существовать без каких-либо отчетливых клинических проявлений, поэтому для мужчин характерна более поздняя диагностика заболевания, чем для женщин. Своевременная диагностика и адекватное лечение позволяют значительно улучшить качество жизни пациента, восстановить репродуктивную функцию, а медикаментозная терапия агонистами дофамина играет заслуженно важную роль в лечении пациентов с пролактиномами. Мы представляем российский опыт применения препарата Агалатес у пациента с пролактинсекретирующей макроаденомой гипофиза и анализ его благоприятных эффектов на клинические и метаболические проявления заболевания.
Ключевые слова: гиперпролактинемия, пролактинома, агонист дофамина, каберголин, Агалатес.
Ключевые слова: гиперпролактинемия, пролактинома, агонист дофамина, каберголин, Агалатес.
________________________________________________
Hyperprolactinemia is a severe neuroendocrine disease that develops when the pituitary gland produces of excess prolacin (Prl). Hyperprolactinemia is not only a sexual and reproductive problem. Hypersecretion of Prl leads to variety complications, decreased quality of life, shortening the expected lifespan due to development of severe neuroendocrine complications. Timely diagnosis and adequate treatment can restore reproductive gunction and medical therapy deservedly plays an important role in treatment of patients with hyperprolactinemia. We present a Russian experience of patient with prolactinoma treatment with new preparation – Agalates, with analysis of its favorable effects on clinical and metabolic manifestations of the disease.
Key words: hyperprolactinemia, prolactinoma, dopamine agonist, cabergoline, Agalates.
Полный текст
Список литературы
1. Дедов И.И., Мельниченко Г.А., Романцова Т.И. Синдром гиперпролактинемии. М.: Триада, 2004; с. 304.
2. Davis JR, Farrell WE, Clayton RN. Pituitary tumours. Reproduction 2001; 121 (3): 363–71.
3. Colao A, Di Sarno A, Cappabianca P. Gender differences in the prevalence, clinical features and response to cabergoline in hyperprolactinemia. Eur J Endocrinol 2003; 148 (3): 325–31.
4. Colao A, Vitale G, Di Sarno A et al. Prolactin and Prostate Hypertrophy: A Pilot Observational, Prospective, Case-Control Study in Men with Prolactinoma. J Clin Endocrinol Metab 89 (6): 2770–5.
5. Casanueva F, Molitch M, Schlechte J et al. Guidelines of the piuitary Society for the diagnosis and management of prolactinomas. Clin Endocrinol 2006; 65: 265–73.
6. Gokalp HZ, Deda H, Attar A et al. The neurosurgical management of prolactinomas. J Neurosurg Sci 2000; 44: 128–32.
7. Kristof RA, Schramm J, Redel et al. Endocrinological outcome following first time transsphenoidal surgery for GH-ACTH-, and PRL-secreting pituitary adenomas. Acta Neurochir (Wien) 2002; 144: 555–61.
8. Molitch ME. Medical Management of Prolactin-Secreting Pituitary Adenomas. Pituitary 2002; 5: 55–65.
9. Colao A, Di Sarno A, Cappabianca P et al. Withdrawal of Long-Term Cabergoline Therapy for Tumoral and Nontumoral Hyperprolactinemia. N Engl J Med 2003; 349: 2023–33.
10. Di Sarno A, Landi ML, Cappabianca P et al. Resistance to cabergoline as compared with bromocriptine in hyperprolactinemia: prevalence, clinical definition, and therapeutic strategy. J Clin Endocrinol Metab 2001; 86: 5256–61.
11. Cohen DL, Bevan JS, Adams CB. The presentation and management of pituitary tumours in the elderly. Age Ageing 1989; 18 (4): 247–52.
12. Eguchi K, Kawamoto K, Uozumi T et al. In vivo effect of cabergoline, a dopamine agonist, on estrogen-induced rat pituitary tumors. Endocr J 1995; 42: 153–61.
13. Eguchi K, Kawamoto K, Uozumi T et al. Effect of cabergoline, a dopamine agonist, on estrogen-induced rat pituitary tumors: in vitro culture studies. Endocr J 1995; 42: 413–20.
14. Colao A, Di Sarno A, Sarnacchiaro F et al. Prolactinomas Resistant to Standard Dopamine Agonists Respond to Chronic Cabergoline Treatment. Journal of Clinical Endocrinology and Metabolism, 82 (3): 876–83.
15. Colao A, Vitale G, Cappabianca P. Outcome of Cabergoline treatment in men with prolactinoma: Effects of a 24-months treatment on prolactin levels, tumor mass, recovery of pituitari function, and semen analysis. J Clin Endocrinol Metab 2004; 89: 1704–11.
16. Colao A, Di Sarno A, Landi ML et al. Long-term and low-dose treatment with cabergoline induces macroprolactinoma shrinkage. J Clin Endocrinol Metab 1997; 82: 3574–9.
17. Rains CP, Bryson HM, Fitton A. Cabergoline. A review of its pharmacological properties and therapeutic potential in the treatment of hyperprolactinaemia and inhibition of lactation. Drugs 1995; 49: 255–79.
18. Webster JA. Comparative review of the tolerability profiles of dopamine agonists in the treatment of hyperprolactinaemia and inhibition of lactation. Drug Saf 1996; 14: 228–38.
19. Colao A, Maurizio G, Di Sarno A et al. Increased prevalence of tricuspidal regurgitation in patients with prolactinomas chronically treated with cabergoline. J Clin Endocrinol Metab 2008; 93 (10): 3777–84.
20. Pelkonen R, Nikkilä EA, Grahne B. Serum lipids, postheparin plasma lipase activities and glucose tolerance in patients with prolactinoma. Clin Endocrinol (Oxf) 1982; 16 (4): 383–90.
2. Davis JR, Farrell WE, Clayton RN. Pituitary tumours. Reproduction 2001; 121 (3): 363–71.
3. Colao A, Di Sarno A, Cappabianca P. Gender differences in the prevalence, clinical features and response to cabergoline in hyperprolactinemia. Eur J Endocrinol 2003; 148 (3): 325–31.
4. Colao A, Vitale G, Di Sarno A et al. Prolactin and Prostate Hypertrophy: A Pilot Observational, Prospective, Case-Control Study in Men with Prolactinoma. J Clin Endocrinol Metab 89 (6): 2770–5.
5. Casanueva F, Molitch M, Schlechte J et al. Guidelines of the piuitary Society for the diagnosis and management of prolactinomas. Clin Endocrinol 2006; 65: 265–73.
6. Gokalp HZ, Deda H, Attar A et al. The neurosurgical management of prolactinomas. J Neurosurg Sci 2000; 44: 128–32.
7. Kristof RA, Schramm J, Redel et al. Endocrinological outcome following first time transsphenoidal surgery for GH-ACTH-, and PRL-secreting pituitary adenomas. Acta Neurochir (Wien) 2002; 144: 555–61.
8. Molitch ME. Medical Management of Prolactin-Secreting Pituitary Adenomas. Pituitary 2002; 5: 55–65.
9. Colao A, Di Sarno A, Cappabianca P et al. Withdrawal of Long-Term Cabergoline Therapy for Tumoral and Nontumoral Hyperprolactinemia. N Engl J Med 2003; 349: 2023–33.
10. Di Sarno A, Landi ML, Cappabianca P et al. Resistance to cabergoline as compared with bromocriptine in hyperprolactinemia: prevalence, clinical definition, and therapeutic strategy. J Clin Endocrinol Metab 2001; 86: 5256–61.
11. Cohen DL, Bevan JS, Adams CB. The presentation and management of pituitary tumours in the elderly. Age Ageing 1989; 18 (4): 247–52.
12. Eguchi K, Kawamoto K, Uozumi T et al. In vivo effect of cabergoline, a dopamine agonist, on estrogen-induced rat pituitary tumors. Endocr J 1995; 42: 153–61.
13. Eguchi K, Kawamoto K, Uozumi T et al. Effect of cabergoline, a dopamine agonist, on estrogen-induced rat pituitary tumors: in vitro culture studies. Endocr J 1995; 42: 413–20.
14. Colao A, Di Sarno A, Sarnacchiaro F et al. Prolactinomas Resistant to Standard Dopamine Agonists Respond to Chronic Cabergoline Treatment. Journal of Clinical Endocrinology and Metabolism, 82 (3): 876–83.
15. Colao A, Vitale G, Cappabianca P. Outcome of Cabergoline treatment in men with prolactinoma: Effects of a 24-months treatment on prolactin levels, tumor mass, recovery of pituitari function, and semen analysis. J Clin Endocrinol Metab 2004; 89: 1704–11.
16. Colao A, Di Sarno A, Landi ML et al. Long-term and low-dose treatment with cabergoline induces macroprolactinoma shrinkage. J Clin Endocrinol Metab 1997; 82: 3574–9.
17. Rains CP, Bryson HM, Fitton A. Cabergoline. A review of its pharmacological properties and therapeutic potential in the treatment of hyperprolactinaemia and inhibition of lactation. Drugs 1995; 49: 255–79.
18. Webster JA. Comparative review of the tolerability profiles of dopamine agonists in the treatment of hyperprolactinaemia and inhibition of lactation. Drug Saf 1996; 14: 228–38.
19. Colao A, Maurizio G, Di Sarno A et al. Increased prevalence of tricuspidal regurgitation in patients with prolactinomas chronically treated with cabergoline. J Clin Endocrinol Metab 2008; 93 (10): 3777–84.
20. Pelkonen R, Nikkilä EA, Grahne B. Serum lipids, postheparin plasma lipase activities and glucose tolerance in patients with prolactinoma. Clin Endocrinol (Oxf) 1982; 16 (4): 383–90.
________________________________________________
1. Дедов И.И., Мельниченко Г.А., Романцова Т.И. Синдром гиперпролактинемии. М.: Триада, 2004; с. 304.
2. Davis JR, Farrell WE, Clayton RN. Pituitary tumours. Reproduction 2001; 121 (3): 363–71.
3. Colao A, Di Sarno A, Cappabianca P. Gender differences in the prevalence, clinical features and response to cabergoline in hyperprolactinemia. Eur J Endocrinol 2003; 148 (3): 325–31.
4. Colao A, Vitale G, Di Sarno A et al. Prolactin and Prostate Hypertrophy: A Pilot Observational, Prospective, Case-Control Study in Men with Prolactinoma. J Clin Endocrinol Metab 89 (6): 2770–5.
5. Casanueva F, Molitch M, Schlechte J et al. Guidelines of the piuitary Society for the diagnosis and management of prolactinomas. Clin Endocrinol 2006; 65: 265–73.
6. Gokalp HZ, Deda H, Attar A et al. The neurosurgical management of prolactinomas. J Neurosurg Sci 2000; 44: 128–32.
7. Kristof RA, Schramm J, Redel et al. Endocrinological outcome following first time transsphenoidal surgery for GH-ACTH-, and PRL-secreting pituitary adenomas. Acta Neurochir (Wien) 2002; 144: 555–61.
8. Molitch ME. Medical Management of Prolactin-Secreting Pituitary Adenomas. Pituitary 2002; 5: 55–65.
9. Colao A, Di Sarno A, Cappabianca P et al. Withdrawal of Long-Term Cabergoline Therapy for Tumoral and Nontumoral Hyperprolactinemia. N Engl J Med 2003; 349: 2023–33.
10. Di Sarno A, Landi ML, Cappabianca P et al. Resistance to cabergoline as compared with bromocriptine in hyperprolactinemia: prevalence, clinical definition, and therapeutic strategy. J Clin Endocrinol Metab 2001; 86: 5256–61.
11. Cohen DL, Bevan JS, Adams CB. The presentation and management of pituitary tumours in the elderly. Age Ageing 1989; 18 (4): 247–52.
12. Eguchi K, Kawamoto K, Uozumi T et al. In vivo effect of cabergoline, a dopamine agonist, on estrogen-induced rat pituitary tumors. Endocr J 1995; 42: 153–61.
13. Eguchi K, Kawamoto K, Uozumi T et al. Effect of cabergoline, a dopamine agonist, on estrogen-induced rat pituitary tumors: in vitro culture studies. Endocr J 1995; 42: 413–20.
14. Colao A, Di Sarno A, Sarnacchiaro F et al. Prolactinomas Resistant to Standard Dopamine Agonists Respond to Chronic Cabergoline Treatment. Journal of Clinical Endocrinology and Metabolism, 82 (3): 876–83.
15. Colao A, Vitale G, Cappabianca P. Outcome of Cabergoline treatment in men with prolactinoma: Effects of a 24-months treatment on prolactin levels, tumor mass, recovery of pituitari function, and semen analysis. J Clin Endocrinol Metab 2004; 89: 1704–11.
16. Colao A, Di Sarno A, Landi ML et al. Long-term and low-dose treatment with cabergoline induces macroprolactinoma shrinkage. J Clin Endocrinol Metab 1997; 82: 3574–9.
17. Rains CP, Bryson HM, Fitton A. Cabergoline. A review of its pharmacological properties and therapeutic potential in the treatment of hyperprolactinaemia and inhibition of lactation. Drugs 1995; 49: 255–79.
18. Webster JA. Comparative review of the tolerability profiles of dopamine agonists in the treatment of hyperprolactinaemia and inhibition of lactation. Drug Saf 1996; 14: 228–38.
19. Colao A, Maurizio G, Di Sarno A et al. Increased prevalence of tricuspidal regurgitation in patients with prolactinomas chronically treated with cabergoline. J Clin Endocrinol Metab 2008; 93 (10): 3777–84.
20. Pelkonen R, Nikkilä EA, Grahne B. Serum lipids, postheparin plasma lipase activities and glucose tolerance in patients with prolactinoma. Clin Endocrinol (Oxf) 1982; 16 (4): 383–90.
Авторы
Е.Н.Гиниятуллина
ФГУ Научный центр акушерства, гинекологии и перинатологии им. В.И.Кулакова Минздравсоцразвития РФ
ФГУ Научный центр акушерства, гинекологии и перинатологии им. В.И.Кулакова Минздравсоцразвития РФ
________________________________________________
E.N.Giniyatullina
Federal State Enterprise Research Centre for Obstetrics, Gynaecology and Perinatology named after V. I. Kulakov, Ministry of Public Health and Social Development of the Russian Federation
Цель портала OmniDoctor – предоставление профессиональной информации врачам, провизорам и фармацевтам.