Controversial issues in the management of hyperprolactinemia and prolactinomas - An overview by the Neuroendocrinology Department of the Brazilian Society of Endocrinology and Metabolism

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dc.citation.issue2
dc.citation.volumev. 62
dc.contributor.authorVilar, Lucio
dc.contributor.authorAbucham, Julio [UNIFESP]
dc.contributor.authorAlbuquerque, Jose Luciano
dc.contributor.authorAraujo, Luiz Antonio
dc.contributor.authorAzevedo, Monalisa F.
dc.contributor.authorBoguszewski, Cesar Luiz
dc.contributor.authorCasulari, Luiz Augusto
dc.contributor.authorCunha Neto, Malebranche B. C.
dc.contributor.authorCzepielewski, Mauro A.
dc.contributor.authorDuarte, Felipe H. G.
dc.contributor.authorFaria, Manuel dos S.
dc.contributor.authorGadelha, Monica R.
dc.contributor.authorGarmes, Heraldo M.
dc.contributor.authorGlezer, Andrea
dc.contributor.authorGurgel, Maria Helane
dc.contributor.authorJallad, Raquel S.
dc.contributor.authorMartins, Manoel
dc.contributor.authorMiranda, Paulo A. C.
dc.contributor.authorMontenegro, Renan M.
dc.contributor.authorMusolino, Nina R. C.
dc.contributor.authorNaves, Luciana A.
dc.contributor.authorRibeiro-Oliveira Junior, Antonio
dc.contributor.authorSilva, Cintia M. S.
dc.contributor.authorViecceli, Camila
dc.contributor.authorBronstein, Marcello D.
dc.coverageRio De Janeiro, Rj
dc.date.accessioned2020-07-20T16:31:17Z
dc.date.available2020-07-20T16:31:17Z
dc.date.issued2018
dc.description.abstractProlactinomas are the most common pituitary adenomas (approximately 40% of cases), and they represent an important cause of hypogonadism and infertility in both sexes. The magnitude of prolactin (PRL) elevation can be useful in determining the etiology of hyperprolactinemia. Indeed, PRL levels > 250 ng/mL are highly suggestive of the presence of a prolactinoma. In contrast, most patients with stalk dysfunction, drug-induced hyperprolactinemia or systemic diseases present with PRL levels < 100 ng/mL. However, exceptions to these rules are not rare. On the other hand, among patients with macroprolactinomas (MACs), artificially low PRL levels may result from the so-called "hook effect". Patients harboring cystic MACs may also present with a mild PRL elevation. The screening for macroprolactin is mostly indicated for asymptomatic patients and those with apparent idiopathic hyperprolactinemia. Dopamine agonists (DAs) are the treatment of choice for prolactinomas, particularly cabergoline, which is more effective and better tolerated than bromocriptine. After 2 years of successful treatment, DA withdrawal should be considered in all cases of microprolactinomas and in selected cases of MACs. In this publication, the goal of the Neuroendocrinology Department of the Brazilian Society of Endocrinology and Metabolism (SBEM) is to provide a review of the diagnosis and treatment of hyperprolactinemia and prolactinomas, emphasizing controversial issues regarding these topics. This review is based on data published in the literature and the authors' experience.en
dc.description.affiliationUniv Fed Pernambuco UFPE, Serv Endocrinol, Hosp Clin, Recife, PE, Brazil
dc.description.affiliationUniv Fed Sao Paulo Unifesp, EPM, Unidade Neuroendocrino, Sao Paulo, SP, Brazil
dc.description.affiliationCtr Endocrinol & Diabet Joinville Endoville, Joinville, SC, Brazil
dc.description.affiliationUniv Brasilia UnB, Serv Endocrinol, Brasilia, DF, Brazil
dc.description.affiliationUniv Fed Parana SEMPR, Serv Endocrinol & Metabol, Hosp Clin, Curitiba, PR, Brazil
dc.description.affiliationUniv Sao Paulo IPq HC FMUSP, Div Neurocirurgia Func, Inst Psiquiatria, Hosp Clin,Fac Med, Sao Paulo, SP, Brazil
dc.description.affiliationUniv Fed Rio Grande do Sul, Serv Endocrinol, Hosp Clin Porto Alegre, PPG Endocrinol,Fac Med, Porto Alegre, RS, Brazil
dc.description.affiliationUniv Sao Paulo FMUSP, Fac Med, Serv Endocrinol, Hosp Clin, Sao Paulo, SP, Brazil
dc.description.affiliationUniv Fed Maranhao UFMA, Serv Endocrinol, Hosp Univ Presidente Dutra, Sao Luis, MA, Brazil
dc.description.affiliationUniv Fed Rio de Janeiro, HUCFF, Serv Endocrinol, Rio de Janeiro, RJ, Brazil
dc.description.affiliationInst Estadual Cerebro Paulo Niemeyer, Unidade Neuroendocrinol, Rio De Janeiro, RJ, Brazil
dc.description.affiliationUniv Estadual Campinas FCM Unicamp, Dept Clin Med, Fac Ciencias Med, Campinas, SP, Brazil
dc.description.affiliationUniv Fed Ceara UFCE, Serv Endocrinol, Hosp Univ Walter Cantidio, Fortaleza, Ceara, Brazil
dc.description.affiliationSanta Casa Belo Horizonte, Serv Endocrinol & Metabol, Belo Horizonte, MG, Brazil
dc.description.affiliationUniv Fed Minas Gerais, Serv Endocrinol, Hosp Clin, Belo Horizonte, MG, Brazil
dc.description.affiliationUnifespUniv Fed Sao Paulo Unifesp, EPM, Unidade Neuroendocrino, Sao Paulo, SP, Brazil
dc.description.sourceWeb of Science
dc.format.extent236-263
dc.identifierhttp://dx.doi.org/10.20945/2359-3997000000032
dc.identifier.citationArchives Of Endocrinology Metabolism. Rio De Janeiro, Rj, v. 62, n. 2, p. 236-263, 2018.
dc.identifier.doi10.20945/2359-3997000000032
dc.identifier.fileS2359-39972018000200236.pdf
dc.identifier.issn2359-3997
dc.identifier.scieloS2359-39972018000200236
dc.identifier.urihttps://repositorio.unifesp.br/handle/11600/55852
dc.identifier.wosWOS:000432093700016
dc.language.isoeng
dc.publisherSbem-Soc Brasil Endocrinologia & Metabologia
dc.relation.ispartofArchives Of Endocrinology Metabolism
dc.rightsinfo:eu-repo/semantics/openAccess
dc.subjectHyperprolactinemiaen
dc.subjectprolactinomasen
dc.subjectpseudoprolactinomasen
dc.subjectmacroprolactinen
dc.subjecthook-effecten
dc.subjectdopamine agonistsen
dc.subjectpituitary surgeryen
dc.subjecttemozolomideen
dc.titleControversial issues in the management of hyperprolactinemia and prolactinomas - An overview by the Neuroendocrinology Department of the Brazilian Society of Endocrinology and Metabolismen
dc.typeinfo:eu-repo/semantics/review
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