Giant macroprolactinoma and pregnancy.
Prolactinomas are a common cause of gonadal dysfunction and infertility. We present the case of a 38-year-old woman with history of amenorrhea and infertility. At seven weeks of pregnancy she presented neuro-ophthalmologic complaints of headaches, diplopia, and right ptosis. The work-up study revealed an invasive pituitary macroadenoma with a maximum diameter of 9 cm and serum prolactin of 25,800 ng/mL (3-20). At 12 weeks, she was referred to the Endocrinology Department of the Coimbra University Hospital and started therapy with bromocriptine, initially 5 mg/day and then at crescent doses. Hyperprolactinemia was rapidly and drastically reduced to 254 ng/mL three weeks after taking bromocriptine 15 mg/day. Tumoral volume was reduced and there was improvement of III pair paresis. At 38 weeks, a male healthy baby was born. This is a relevant clinical case that illustrates the efficacy and safety of bromocriptine therapy during pregnancy, even in severe cases like this one.
Joana
J
Saraiva
Leonor
L
Gomes
Sandra
S
Paiva
Luisa
L
Ruas
Manuela
M
Carvalheiro
D000328:Adult; D001971:Bromocriptine / Q000008:administration & dosage*; D018491:Dopamine Agonists / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D006966:Hyperprolactinemia / Q000150:complications; D007231:Infant, Newborn; D007247:Infertility, Female / Q000209:etiology; D008297:Male; D010911:Pituitary Neoplasms / Q000188:drug therapy* / Q000473:pathology; D011247:Pregnancy; D011252:Pregnancy Complications, Neoplastic / Q000188:drug therapy*; D011388:Prolactin / Q000097:blood; D015175:Prolactinoma / Q000097:blood / Q000188:drug therapy*; D016896:Treatment Outcome
D018491:Dopamine Agonists; D001971:Bromocriptine; D011388:Prolactin