Long-term follow-up of 246 hyperprolactinemic patients.
BACKGROUND
We wanted to evaluate the very long-term effects of bromocriptine on prolactin (PRL) levels and pituitary tumor size in a large cohort of hyperprolactinemic patients.


METHODS
We conducted a retrospective cohort study in the Department of Endocrinology from Necker Hospital in Paris, France. Two hundred and forty-six patients consulted primarily for menstrual disorders, with diagnosis of hyperprolactinemia. Patients were followed-up for 99.9+/-3.6 months. One hundred and ninety-one were treated with bromocriptine, 32 underwent surgery, and 23 received no treatment.


RESULTS
The mean initial plasma PRL level was 135.0+/-20.2 ng/ml. Presence of an adenoma was detected in 60% of our patients and comprised a microadenoma in 64% of cases. Compared to oligomenorrheic women, amenorrheic patients had significantly higher levels of PRL and larger pituitary tumor size. In the bromocriptine group, PRL levels decreased from 99.6+/-7.9 to 20.0+/-1.5 ng/ml (p=0.00001). The medical treatment was associated with disappearance of the adenoma in 45% of the women and with stabilization of pituitary tumor size in 40% of patients. Surgery led to disappearance of the adenoma in almost all cases, but failed to definitively cure hyperprolactinemia.


CONCLUSIONS
In this large-scale retrospective study, the medical treatment of mild hyperprolactinemia was shown to be effective and sufficient after 9 years of follow-up.
Touraine
P
P
Department of Endocrinology and Reproductive Medicine, H pital Necker, Paris, France.
Plu-Bureau
G
G
Beji
C
C
Mauvais-Jarvis
P
P
Kuttenn
F
F
D000236:Adenoma / Q000150:complications / Q000188:drug therapy / Q000601:surgery; D000328:Adult; D001971:Bromocriptine / Q000627:therapeutic use*; D004958:Estradiol / Q000097:blood; D005260:Female; D005500:Follow-Up Studies; D006727:Hormone Antagonists / Q000627:therapeutic use*; D006801:Humans; D006966:Hyperprolactinemia / Q000188:drug therapy* / Q000209:etiology; D010911:Pituitary Neoplasms / Q000150:complications / Q000188:drug therapy / Q000601:surgery; D011388:Prolactin / Q000097:blood; D012189:Retrospective Studies
D006727:Hormone Antagonists; D001971:Bromocriptine; D004958:Estradiol; D011388:Prolactin