95%.CONCLUSIONS: A rapid decline in prolactin level can be seen in prolactinomas upon initiation of DA therapy. This significant prolactin drop restricts the ability to establish a threshold beyond which the diagnosis of prolactinoma could be excluded." />
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Hage C, Salvatori R. Speed of response to dopaminergic agents in prolactinomas. Endocrine. 2021;doi: 10.1007/s12020-021-02953-1.
Hage, C., & Salvatori, R. (2021). Speed of response to dopaminergic agents in prolactinomas. Endocrine, . https://doi.org/10.1007/s12020-021-02953-1
Hage, Camille, and Salvatori, Roberto. "Speed of response to dopaminergic agents in prolactinomas." Endocrine vol. (2021). doi: https://doi.org/10.1007/s12020-021-02953-1
Hage C, Salvatori R. Speed of response to dopaminergic agents in prolactinomas. Endocrine. 2021 Nov 30; doi: 10.1007/s12020-021-02953-1. Epub 2021 Nov 30. PMID: 34846682.
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Endocrine. 2021 Nov 30; doi: 10.1007/s12020-021-02953-1. Epub 2021 Nov 30.

Speed of response to dopaminergic agents in prolactinomas.

Endocrine

Camille Hage, Roberto Salvatori

Affiliations

  1. Division of Endocrinology, Diabetes, & Metabolism, Department of Medicine, and Pituitary Center, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
  2. Division of Endocrinology, Diabetes, & Metabolism, Department of Medicine, and Pituitary Center, Johns Hopkins University School of Medicine, Baltimore, MD, USA. [email protected].

PMID: 34846682 DOI: 10.1007/s12020-021-02953-1

Abstract

PURPOSE: Hyperprolactinemia in the presence of a sellar lesion can be caused by prolactin secretion from the lesion, or by increased intrasellar pressure/compression of the pituitary stalk ("stalk effect"). The objective of this work was to determine the response to dopamine agonists (DAs) in bona fide prolactinomas presenting with a prolactin range similar to what can be seen in nonhormonal secreting pituitary tumors.

METHODS: A descriptive study on 68 prolactinomas presenting with prolactin levels between 50 and 200 ng/mL in a tertiary center in the U.S.A. over 22 years. The main outcome was prolactin decrease from diagnosis to follow-up by 2 months from initiation of DA therapy.

RESULTS: With a median time to follow-up from starting DA therapy of 5 weeks [IQR:4, 6], the median prolactin check showed normality at 11.85 ng/mL [IQR: 5.1, 29]. The median prolactin percent change was at 87% [IQR:67, 94] by 2 months. The majority (75%) of patients presenting had a 2/3 (67%) prolactin drop by 2 months, with more than 1/4 (25%) having a percent drop >95%.

CONCLUSIONS: A rapid decline in prolactin level can be seen in prolactinomas upon initiation of DA therapy. This significant prolactin drop restricts the ability to establish a threshold beyond which the diagnosis of prolactinoma could be excluded.

© 2021. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.

Keywords: Cabergoline; Dopamine Agents; Hyperprolactinemia; Prolactinoma

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