[Role of hypothalamo-hypophyseal-adrenal axis in the pathogenesis of arterial hypertension in patients with prolactinoma of the anterior lobe of the hypophysis].
OBJECTIVE
To elucidate mechanisms underlying arterial hypertension (AH) in patients with hyperprolactinemia, prolactin-secreting adenoma of the anterior lobe of the hypothesis, in particular.


METHODS
9 females with microprolactin-secreting and 4 females with macroprolactin-secreting adenoma of the anterior lobe of the hypophysis (mean age 33.8 +/- 3.7 years) were examined using radioimmunoassay of the hormones, computed tomography, MR-tomography of the adrenals and brain.


RESULTS
Humoral regulation of the hypothalamic-hypophyseal-adrenal axis was found different in patients with microadenoma due to dopaminergic insufficiency of the hypothalamus and in patients with macroadenoma--tumor of the hypophyseal genesis. Patients with microadenoma were diagnosed to have low-renin diastolic arterial hypertension with clinical symptoms of hyperaldosteronism and high levels of plasma aldosterone. Patients with macroadenoma had normal arterial pressure, aldosterone levels and plasma renin activity. Treatment with parlodel, agonist of dopaminergic receptors, reduced arterial pressure, prolactin level, plasma aldosterone and raised plasma renin activity in patients with microadenoma. Such changes were not observed in patients with macroadenoma.


CONCLUSIONS
It is suggested that one of the causes of AH in patients with microprolactin-secreting hypophyseal adenoma lies in hyperaldosteronemia which develops as a result of dopaminergic insufficiency of the hypothalamus and hyperprolactinemia.
Mychka
V B
VB
Chazova
I E
IE
Dmitriev
V V
VV
Masenko
V P
VP
D000328:Adult; D000450:Aldosterone / Q000097:blood; D001971:Bromocriptine / Q000627:therapeutic use; D003627:Data Interpretation, Statistical; D004298:Dopamine / Q000652:urine; D018491:Dopamine Agonists / Q000627:therapeutic use; D005260:Female; D006801:Humans; D006929:Hyperaldosteronism / Q000209:etiology; D006966:Hyperprolactinemia / Q000209:etiology; D006973:Hypertension / Q000097:blood / Q000209:etiology* / Q000503:physiopathology; D007030:Hypothalamo-Hypophyseal System / Q000502:physiology*; D010911:Pituitary Neoplasms / Q000097:blood / Q000150:complications* / Q000188:drug therapy / Q000503:physiopathology; D010913:Pituitary-Adrenal System / Q000502:physiology*; D011388:Prolactin / Q000097:blood; D015175:Prolactinoma / Q000097:blood / Q000150:complications* / Q000188:drug therapy / Q000503:physiopathology; D011863:Radioimmunoassay; D012083:Renin / Q000097:blood
D018491:Dopamine Agonists; D001971:Bromocriptine; D000450:Aldosterone; D011388:Prolactin; D012083:Renin; D004298:Dopamine