A. D'Alberton

Dose‐dependent suppression of serum prolactin by cabergoline in hyperprolactinaemia: a placebo controlled, double blind, multicentre study

OBJECTIVE Dopamine agonists have a well established place in the treatment of hyperprolactinaemic disorders but their use is associated with a high incidence of adverse effects. We have investigated the biochemical efficacy and side‐effect profile of a range of doses of the novel, long‐acting dopamine agonist, cabergoline, in suppressing prolactin (PRL) in hyperprolactinaemic women.

Spontaneous remission of Cushing syndrome after termination of pregnancy.

A 27-year-old women developed Cushing syndrome during pregnancy. The course of pregnancy was characterized by abnormally low urine and plasma estrogen levels despite the presence of a living fetus. The signs and symptoms of Cushing syndrome disappeared spontaneously within 2 months after delivery. Hormonal studies, however, suggested the presence of an adrenal tumor. An adrenocortical adenoma was found at surgery and removed.

Radioimmunoassayable plasma luteinizing hormone in primary amenorrhea

Plasma luteinizing hormone (LH) was detectable by radioimmunoassay in 35 patients, all with female external genitalia, who had never menstruated spontaneously. Patients were grouped as follows: 11 with hypogonadotropic hypogonadism (1 pituitary dwarf, all with normal sex chromatin) 16 with gonadal dysgenesis (5 XO, 5 XX, 2 XY, 3 mosaics), and 8 with uterovaginal atresia (normal karyotypes.) Radioimmunoassay was performed with rabbit anti-human chorionic gonadotropin labeled with iodine-125, by the polystyrene tube method, on plasma samples taken at 9-11 a.m. Hypogonadism patients had mean 9.1 mI.U. LH (range 0-18); gonadal dysgenesis patients had mean 61.5 (range 23-103); uterovaginal atresia patients had 11.9 (0-35). It was noteworthy that no overlap was observed between primary gonadal failure (gonadal dysgensis), and secondary (hypogonadism), and that LH values in 2 other patients with polycystic ovaries, LH was 16 and 34 mI.U. and FSH was not increased.

Increased Forearm Bone Mineral Content after Bromocriptine Treatment in Hyperprolactinemia

SummaryWe studied 15 hyperprolactinemic women to evaluate possible modifications of bone mineral content after pharmacological treatment. Patients received a dopamine agonist (bromocriptine) for six months after which there was a significant decrease of prolactin plasma levels (P<0.01) and a significant increase of bone mineral content (F<0.05)

Antiserotonin treatment of hyperprolactinemic amenorrhea: long-term follow-up with metergoline, methysergide, and cyproheptadine.

Twenty patients affected by hyperprolactinemic amenorrhea-galactorrhea have been treated with one or more of the following serotonin antagonists: metergoline, methysergide, and cyproheptadine. Among the 11 patients without evidence of pituitary tumor resumption of menses was observed in five, two of whom had ovulatory cycles; one patient became pregnant; ovulations occurred only during treatment with metergoline. In the group of nine patients with enlarged sellae, three experienced isolated episodes of bleeding, while two had three and four menses each, respectively; all cycles were anovulatory. Plasma prolactin levels and galactorrhea were favorably affected by treatment only in a minority of amenorrhea-galactorrhea patients with and without tumors.

PREGNANCY FOLLOWING METERGOLINE TREATMENT IN A PATIENT WITH HYPERPROLACTINAEMIA

A 33‐year‐old woman who had had amenorrhoea and galactorrhoea for ten years and had hyperprolactinaemia was treated with metergoline, a serotonin antagonist. There was a marked decrease in plasma prolactin levels. After two months, ovulation and pregnancy occurred. This is the first such report.

Plasma gonadotropin and ovarian steroid levels in uterovaginal atresia: A case report

Abstract The pituitary-ovarian relationship was studied in a 26-year-old patient with uterovaginal atresia. The plasma levels of luteinizing hormone, follicle-stimulating hormone, progesterone, and estradiol were determined daily for a months period. They showed cyclic variations similar to those of normally menstruating women.

CIRCADIAN RHYTHM OF PLASMA CORTICOSTEROIDS IN CONGENITAL ADRENAL HYPERPLASIA

Circadian rhythm and dexamethasone suppression of plasma fluorogenic corticosteroids and plasma progesterone were studied in six patients with the simple virilizing form of congenital adrenal hyperplasia. Basal levels of plasma fluorogenic steroids were normal or high in the untreated patients. A definite circadian variation was demonstrated, suggesting a similar variation in ACTH secretion. Dexamethasone administration in the form of the overnight suppression test was followed by a virtually complete disappearance of plasma fluorescence. Plasma progesterone levels were high in the morning hours and showed a circadian variation and dexamethasone suppression similar to those of fluorogenic steroids. The diagnostic and therapeutic importance of these findings is discussed.

Variability of gonadotropin response to luteinizing hormone-releasing hormone in amenorrheic women

Abstract Plasma gonadotropin response to luteinizing hormone-releasing hormone (LH-RH) (200 μg intravenously) has been evaluated in a group of amenorrheic women. Eleven of them had primary amenorrhea due to isolated gonadotropin deficiency. Fifteen had secondary functional amenorrhea; this group included patients with anorexia nervosa, polycystic ovary, amenorrhea-galactorrhea, idiopathic amenorrhea. Most patients showed a significant elevation of gonadotropin plasma levels after LH-RH injection. However, a marked variability in luteinizing hormone (LH) and follicle-stimulating hormone (FSH) rise was observed. The two groups included both patients with normal LH response and patients with blunted LH response. An evident FSH elevation has been found in the great majority of subjects. A frequent pattern of anomalous response observed in amenorrheic women was the occurrence of a blunted LH response associated with a markedly elevated FSH response.

Growth hormone and ACTH secretory dynamics in Turner's syndrome

The secretory dynamics of GH and ACTH were studied in 14 patients with Turners syndrome. The parameters investigated were plasma GH and cortisol responses to hypoglycemia, plasma cortisol circadian rhythm and suppressibility by dexamethasone, and response of urinary Porter-Silber chromogens to metyrapone. The results were mostly normal. These data do not support the hypothesis suggesting an abnormality of hypothalamic-pituitary function in Turners syndrome.