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      Prolactinomas and Resistance to Dopamine Agonists

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          Among 288 patients with prolactinoma (aged 12-62 years; 242 women), 27 were diagnosed as resistant to bromocriptine as their plasma prolactin (PRL) levels remained elevated despite long-term (3 months or more) treatment at high doses (≧ 15 mg daily). These 18 women and 9 men, aged 29 ± 9 years (mean ± SD, range 13-50), followed-up for 8 ± 4 years, had microadenomas (n = 6) or macroadenomas. They were treated by dopamine agonists alone (n = 6) or associated with surgical or radiation therapy. In 8 cases repetitive surgical treatments were necessary. Among the 24 patients who were treated with the nonergot dopamine agonist CV 205-502 after unsuccessful bromocriptine treatment, half of them (9 women, 3 men) resumed normal PRL levels on doses ranging from 0.15 to 0.45 mg/day. Despite daily doses of CV 205-502 from 0.3 to 0.525 mg, the remaining patients were not normalized by this drug which did not prevent tumor growth in 4 of them. Two patients died from invasive cerebral extensions of their tumor and a third had vertebral metastases with positive anti-PRL immunostaining. It is concluded that bromocriptine-resistant prolactinomas represent the most severe aspect of this disease and that a more powerful dopamine agonist like CV 205-502 is effective in only a fraction of these patients.

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          Author and article information

          Horm Res Paediatr
          Hormone Research in Paediatrics
          S. Karger AG
          03 December 2008
          : 38
          : 1-2
          : 84-89
          Service d’Endocrinologie et Maladies Métaboliques, and INSERM U. 297, Centre Hospitalier Universitaire Nord, Marseille, France
          182496 Horm Res 1992;38:84–89
          © 1992 S. Karger AG, Basel

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          Page count
          Pages: 6
          Hormonal Resistance Syndromes


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