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PubMedDate not supplied

Amenorrhea-galactorrhea associated with Cushing's disease due to pituitary tumor.

Two patients with amenorrhea-galactorrhea and Cushing's disease due to pituitary tumor are presented. In both cases, a diagnosis of prolactin-secreting tumor with moderate hyperprolactinemia was established, then Cushing's disease developed years later. Despite the typical clinical features of Cushing's disease, a dexamethasone suppression test inhibited both blood ACTH and cortisol concentrations in the 2 patients. Hypophysectomy was performed in 1 case, and the histologic study revealed the presence of a cromophobe adenoma. The other case was treated by external radiation which improved the clinical situation. Clinical and endocrinological studies in these 2 cases were compared with previous reports in the literature in order to discuss the etiology of this unusual association. It is concluded that patients with pituitary tumors presenting moderate hyperprolactinemia may also have excessive secretion of ACTH.

Adenoma, Chromophobe↗
PubMed1984

Prolactin concentration in milk and plasma of puerperal women and patients with galactorrhea.

Prolactin (PRL) concentration was estimated in milk and blood of women with various types of galactorrhea (n = 53) and was compared with lactating (n = 17) and normally menstruating women (n = 36). Mean milk (+/- SD) PRL concentration in lactating women (160 +/- 66 micrograms/l) was similar to that of galactorrhea due to pituitary adenoma (149 +/- 87 micrograms/l, n = 24), thyroid dysfunction (193 +/- 72 micrograms/l, n = 8), functional causes (192 +/- 91 micrograms/l, n = 10) or recent pregnancy (198 +/- 44 micrograms/l, n = 2), but higher than that of sex steroid-induced galactorrhea (85 +/- 53 micrograms/l, n = 9). Plasma PRL concentration in lactating women (208 +/- 102 micrograms/l) was higher than in normal control women (14 +/- 5 micrograms/l) and patients with galactorrhea due to thyroid dysfunction (36 +/- 15 micrograms/l), functional causes (16 +/- 8 micrograms/l), drugs (20 +/- 4 micrograms/l), recent pregnancy (22 +/- 3 micrograms/l) or pituitary adenoma (145 +/- 53 micrograms/l). The milk to plasma PRL concentration ratio was 0.8 +/- 0.4 in lactating women and 1.1 +/- 0.7 in patients with adenoma but significantly higher (p = 99% two-sided) in galactorrhea due to thyroid dysfunction (4.4 +/- 2.1), drugs (3.4 +/- 1.1) or functional causes (12.3 +/- 4.3). Bromocriptine administration reduced PRL in both fluids. It is concluded that in women with galactorrhea milk PRL concentration is similar to that of nursing mothers, but plasma levels of this hormone are significantly lower than that of the latter group in all but the pituitary adenoma related galactorrheas.

Adenoma↗
PubMed1972

Human prolactin.

Explore the source record for details and available documents.

Animals↗
PubMed2000

Selective acylation of plasma membrane proteins of Mycoplasma agalactiae: the causal agent of agalactia.

Revealed by in vivo labeling with (14)C-palmitic acid, about 15 acylated proteins were identified in the plasma membrane of Mycoplasma agalactiae (type strain PG2), including the major component p40. Triton X-114 phase partitioning and Western blotting demonstrated the amphiphilic properties of the acyl proteins and showed that they were also antigenic components. Chemical analyses of fatty acids bound to proteins revealed the following selectivity order within acylation: stearic acid (18:0) > linoleic acid (18:2c) approximately palmitic acid (16:0) > oleic acid (18:1c) > myristic acid (14:0), with 16:0 and 18:1c preferred for the O-acylation and 18:0 for the N-acylation. The ratio [O-ester- + amide-bound acyl chains]/O-ester-linked chains being close to 1.4 as well as the presence of S-glycerylcysteine suggest that acyl proteins in M. agalactiae are true lipoproteins containing N-acyl diacyl glycerylcysteine, probably processed by a mechanism analogous to that described for Gram-negative eubacteria.

Acylation↗
PubMed2004

[Nucleoside induced hepatopathy in HIV patients. Diagnostic value of liver biopsy assessment].

Hepatic steatosis together with lactic acidosis is a life threatening side effect in HIV infected patients receiving highly active antiretroviral therapy (HAART). We describe 5 patients developing hepatic drug toxicity during longterm treatment with nucleoside reverse transcriptase inhibitors. The main clinical symptoms included abdominal pain, fever, and neurological disorders. Serum lactate levels were elevated leading to severe metabolic acidosis in 3 cases. Liver biopsies revealed extensive macro- and microvesicular steatosis. Mitochondrial alterations were detected by electronmicroscopy. Microvesicular steatosis was seen in one case with elevated liver enzymes, but normal serum lactate levels, and was most extensive in a patient with a severe lactic acidotic coma. We conclude that detection of microvesicular steatosis and mitochondrial alterations in liver biopsies may help to identify the development of a nucleoside induced hepatopathy before the onset of severe lactic acidosis.

Acidosis↗
PubMed1991

Interaction between physiological status in N'Dama cows and trypanosome infections and its effect on health and productivity of cattle in Gambia.

Data collected for three years on incidence of trypanosome infections, degree of anaemia as assessed by packed red cell volume (PCV) and live weights of four groups of cows of varying physiological status were analysed. The animals were not harbouring trypanosomes during a period of two to three months before exposure to periods of increasing density of tsetse flies (Glossina morsitans submorsitans) while grazing in savannah woodlands. The groups of cows were formed on the following basis: pregnant and lactating (lactating-pregnant) (Group 1, n = 143); pregnant and not lactating (dry-pregnant) (Group 2, n = 69); non-pregnant and lactating (lactating-open) (Group 3, n = 160); non-pregnant and not lactating (dry-open) (Group 4, n = 49). Monthly trypanosome prevalence was highest (17.5%) in the cows with the highest physiological stress (Group 1), followed by Group 3 (11.1%) and Group 2 (10.0%) with the lowest prevalence found in the least stressed cows, Group 4 (1.6%). Average PCV values for dry-pregnant cows (Group 2; 27.0%) and dry-open cows (Group 4; 26.2%), whether infected or not, were higher than those lactating (Group 1; 25.3% and Group 3; 23.6%). A body weight gain of 4.3 kg between the month of October and the following June was recorded for dry-pregnant cows (Group 2) whereas a weight loss of 16 kg occurred in the lactating-pregnant and lactating-open cows (Groups 1 and 3), with more severe losses recorded in infected than uninfected cows. Dry-open cows (Group 4) maintained their weight during the observation period.(ABSTRACT TRUNCATED AT 250 WORDS)

Animal Husbandry↗
PubMed1994

Impact of lactation on women with cystic fibrosis and their infants: a review of five cases.

OBJECTIVE: To evaluate the impact of lactation on the health status of women with cystic fibrosis and their infants. DESIGN: Data were acquired through a retrospective review of pulmonary, obstetric, and pediatric medical records. SETTING: A medical school-based Pediatric Cystic Fibrosis Center in Philadelphia, Pa. SUBJECTS: Five women with cystic fibrosis and their respective infants. MAIN OUTCOME MEASURES: For the women, measures of pregravid, gravid, and postpartum height, weight, pulmonary function test results, and energy intake were determined. For the infants, birth Apgar scores were obtained, as were measures of growth and development. STATISTICAL ANALYSES PERFORMED: Means and standard deviations were calculated. Data were compared with published standardized references. RESULTS: Mean maternal age at conception was 25.4 +/- 4.1 years. Mean pregravid weight was 60.0 +/- 10.7 kg of standard body weight for height (range = 50.8 to 76.7 kg; median = 58 kg). Two women consumed up to two enteric-coated supplemental enzyme capsules per meal, three women consumed none. Pulmonary disease was mild in four of the five women. Mean weight gain during pregnancy was 10.2 +/- 7.4 kg. Mean gestation was 37.4 +/- 1.5 weeks; mean birth weight was 3.0 +/- 0.5 kg. Sweat tests performed on all infants were negative. Duration of breast-feeding was 3 to 30 weeks. Four of the five infants maintained appropriate growth velocity during breast-feeding. Mean maternal energy intake during lactation was above the Recommended Dietary Allowance for lactating women. Four of the five women were at or above their standard body weight during lactation. CONCLUSIONS/APPLICATIONS: We conclude that women with the clinical diagnosis of mild cystic fibrosis disease can maintain a normal pregnancy with appropriate weight gain and can deliver infants of normal weight for gestational age. During lactation, women with mild cystic fibrosis disease can maintain their own weight and support growth in healthy infants. The dietitian needs to be an integral member of the health care team in assessing, monitoring, and managing women with cystic fibrosis during their child-bearing years.

Adult↗
PubMed1975

Primary empty sella, galactorrhea, hyperprolactinemia and renal tubular acidosis.

Discussed here is a 41 year old woman with galactorrhea associated with the empty sella syndrome and mild renal tubular acidosis. Basal serum prolactin (PRL) levels were normal, but a 24 hour serum PRL secretory profile demonstrated an increased mean PRL concentration. Serum PRL was appropriately suppressed by the administration of L-dopa; however, chlorpromazine stimulation resulted in a blunted serum PRL response. Pituitary luteinizing hormone, follicle stimulating hormone, ACTH and thyroid stimulating hormone levels were normal. Thus, galactorrhea associated with an enlarged sella does not establish the diagnosis of a pituitary tumor, and pneumoencephalography must be performed to exclude the empty sella syndrome.

Acidosis, Renal Tubular↗
PubMed1977

Primary hypothyroidism and galactorrhea.

Ten of 16 women with primary hypothyroidism and high thyrotropin (TSH) concentrations had high serum prolactin (PRL) concentrations. A positive correlation was observed between the basal TSH and PRL levels in the hypothyroid patients. Five of these patients complained of persistent galactorrhea after delivery. After treatment with triiodothyronine (T3), the elevated TSH and PRL levels fell to within normal ranges, and the galactorrhea disappeared. It is suggested that the elevated serum PRL levels of patients with primary hypothyroidism are mediated by feedback-induced thyrotropin-releasing hormone (TRH) secretion or an enhanced response to endogenous TRH, and that the combination of delivery and the PRL excess may induce persistent galactorrhea in patients with primary hypothyroidism.

Adult↗
PubMed1977

Nonpuerperal galactorrhea and hyperprolactinemia. Clinical findings, endocrine features and therapeutic responses in 56 cases.

The clinical and endocrine features, and the responses to different treatment modalities, were examined in 56 patients with galactorrhea and/or hyperprolactinemia after a two month to six year follow-up period. A pituitary adenoma was diagnosed in 17 patients. A prolactin-cell adenoma was identified histologically in eight patients. Other etiologic factors were myxedema (two patients), phenothiazine ingestion (six patients) and breast manipulation (four patients). In 27 patients, including three with abnormalities of the sella turcica, no causal factor was found, and their condition was labelled as dysfunctional in origin. Symptoms were preceded by childbirth in 11 patients and by estrogen-progestin contraception in 22; pituitary adenomas were discovered in both groups in approximately the same frequency (30%) as in the over-all study group. Aside from roentgenographic studies, as well as visual field perimetry in a few cases, a serum prolactin level above 100 ng/ml was the only indicator of a pituitary prolactin-cell adenoma. Prolactin-suppression tests (L-DOPA and 2alpha-Br-ergocryptine) were found to be of no value in discriminating between tumoral and dysfunctional conditions. No significant alterations in prolactin levels occurred after water loading irrespective of basal levels or the nature of the pathologic process. Selective pituitary tumor excision (eight patients) was followed by rapid normalization of prolactin levels and disappearance of clinical abnormalities. Conversely, after pituitary irradiation (eight patients), improvement tended to be slower. Treatment of infertility in those patients without an apparent organic lesion was more successful with 2alpha-Br-ergocryptine (three of three) than with clomiphene (two of seven). Pregnancies following the administration of drugs or after surgical treatment were uneventful. Since follow-up resulted in the early diagnosis of pituitary tumors from seven to 56 months after initial investigation, and since no diagnostic tools are currently available which help to discriminate between tumoral and dysfunctional conditions before abnormalities become evident on roentgenograms, prolonged observation of these patients remains essential.

Adenoma↗
PubMed1980

Characterization of a pituitary stone.

Calcification of the pituitary is unusual and functional studies of such cases have not been previously reported. We have been able to document persistent prolactin secretion both in vivo and in vitro in a patient with a severely calcified pituitary adenoma ("pituitary stone"), and have also documented prolactin granules within the calcified tissue mass. Normal menstrual function was restored after surgical removal of the "stone," and galactorrhea subsided although the prolactin response to thyrotropin-releasing hormone (TRH) remained abnormal. Two years after surgery the menstrual cycle has remained regular, but galactorrhea has recurred, emphasizing the need for prolonged follow-up in patients with prolactin-producing adenomas, despite apparent surgical cure. The in vitro studies showed that human pituitary tissue is secretory in culture and thus may serve as a useful tool for physiologic studies of the pituitary cell.

Adenoma↗