Hiperprolaktinemisi Olan Pediatrik Olguların Klinik Özelliklerinin ve Hiperprolaktinemi Etiyolojilerinin Değerlendirilmesi
Abstract
Amaç: Bu çalışma, çocuklarda ve ergenlerde prolaktinoma ve makroprolaktineminin sıklığı ve hiperprolaktinemi tanısı konmuş olgularda etiyolojik faktörleri, başvuru şikayetleri, antropometrik ölçümleri ve laboratuvar bulgularını araştırmaktadır.
Yöntemler: Ağustos 2019 ile Ocak 2023 tarihleri arasında tanı alan 38 hiperprolaktinemi vakası değerlendirilmiştir. Çalışmamızda, olguların demografik verileri, semptomları, fizik muayene sonuçlarını ve MRI taramalarından elde edilen hipofiz adenom boyutlarını içeren laboratuvar sonuçları değerlendirilmiştir. Prolaktin düzeyleri, kemilüminesans immünoassay kullanılarak analiz edildi. Makroprolaktin için polietilen glikol çökeltme yöntemi kullanıldı.
Bulgular: Hiperprolaktinemi tanısı konan 38 olgunun, %94,7'si kız olup, ortalama yaşı 15,9±2,3yıldı. En yaygın başvuru şikâyeti menstrual düzensizlik (%45) idi. Olguların %64' ününfizik muayenesinde galaktore saptandı. Vakaların %44,7 'sinde prolaktinoma tespit edilirken, prolaktinomalı olguların prolaktin seviyesi prolaktinoma dışı hiperprolaktinemisi olanlara göre istatistiksel olarak daha yüksek saptandı (p=0,01). Mikroadenomlu olgular %58,8 oranında daha fazla bulunurken, makroadenomlu olgular %41,2 oranında tespit edildi. Tüm hastalar medikal olarak kabergolin ile tedavi edildi, transsfenoidal cerrahi yapılmadı. Prolaktinoma tespit edilen iki olguda ayrıca santral hipotiroidizm eşlik etmekteydi.
Sonuç: Prolaktinoma, nadir görülmesine rağmen çocuklarda ciddi hiperprolaktineminin en yaygın nedenidir. Çalışmamız, klinik semptom göstermeyen ancak artmış prolaktin seviyelerine neden olan ve sıklıkla asemptomatik seyreden makroprolaktinemiye dikkat çekmiştir, özellikle başka bir etiyoloji saptanamadığında ayırıcı tanıda makroprolaktineminin önemi vurgulanmıştır.
References
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- 9.Matalliotakis M, Koliarakis I, Matalliotaki C, TrivliA, Hatzidaki E. Clinical manifestations, evaluationand management of hyperprolactinemia inadolescent and young girls: a brief review. ActaBioMedica: AteneiParmensis. 2019;90(1):149.
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- 12.Petersenn S, Fleseriu M, Casanueva FF, et al.Diagnosis and management of prolactin-secretingpituitary adenomas : a Pituitary Societyinternational Consensus Statement. Nat. Rev.Endocrinol. 2023;19(12):722–40.
- 13.Kontbay T, Şıklar Z, Özsu E et al.Hyperprolactinemia in children and adolescents andlong- term follow-upresults of prolactinomacases : asingle-centre experience. Turk. J. Pediatr.2022;:892–9.
- 14.Harrison JN, Cluxton-Keller F, Gross D.Antipsychotic medication prescribing trends inchildren and adolescents. J. Pediatr. HealthCare.2012 ; 26(2):139–45.
- 15.Rossow KM, Oshikoya KA, Aka IT, et al. Evidencefor pharmacogenomic effects on risperi-doneoutcomes in pediatrics. J Dev Behav Pediatr. 20214;42(3):205.
- 16.Chamnanphon M, Vanwong N, Prommas S, et al.Research in Autism Spectrum DisordersRisperidone plasma concentrations are associatedwith hyperprolactinemia in autism spectrumdisorderchildren : The impact of CYP2D6polymorphisms.Res Autism Spectr Disord. 2022; 96:102002.
- 17. Kalsi AK, Halder A, Jain M, Chaturvedi PK, SharmaJB. Prevalence and reproductive manifestations ofmacroprolactinemia. Endocrine. 2019;63(2):332–40.
- 18.Vilar L, Vilar F, Lyra R, Freitas C. Pitfalls in theDiagnostic Evaluation of Hyperprolactinemia.Neuroendocrinol. 2019;901:7–19.
Abstract
References
- 1.Mancini T, Casanueva FF, Giustina A.Hyperprolactinemia and prolactinomas. Endocrinol.Metab. Clin. N. Am. 2008;37(1):67–99.
- 2. Fahie-Wilson MN, John R, Ellis AR. Macroprolactin;high molecular mass forms of circulating prolactin.Ann. Clin. Biochem. 2005 ;42(Pt 3):175–92.
- 3.Hattori N, Aisaka K, Shimatsu A. A possible causeof the variable detectability of macroprolactin bydifferent immunoassay systems. Clin. Chem.andLabor. Med. 2016 ;54(4):603–8.
- 4.McCudden CR, Sharpless JL, Grenache DG.Comparison of multiple methods for identification ofhyperprolactinemia in the presence ofmacroprolactin. ClinChimActa. 2010 ;411(3–4):155–60.
- 5.Neyzi O, Bundak R, Gökçay G, et al. Referencevalues fo rweight, height, head circumference, andbody mass index in Turkish children. J. Clin. Res.Pediatr.2015;7(4):280.
- 6.Gold EB. Epidemiology of pituitary adenomas.Epidemiol. Rev. 1981;3:163–83.
- 7.Saranac L, Zivanovic S, Radovanovic Z, Kostic G,Markovic I, Miljkovic P. Hyperprolactinemia:different clinical expression in childhood. Horm. Res.Paediatr. 2010;73(3):187–92.
- 8.Catli G, Abaci A, Altincik A, et al.Hyperprolactinemia in children: clinical featuresand long-term results. J. Pediatr. Endocrinol. Metab.2012;25(11–12):1123–8.
- 9.Matalliotakis M, Koliarakis I, Matalliotaki C, TrivliA, Hatzidaki E. Clinical manifestations, evaluationand management of hyperprolactinemia inadolescent and young girls: a brief review. ActaBioMedica: AteneiParmensis. 2019;90(1):149.
- 10.Eren E, Törel Ergür A, Pınar İşgüven Ş, et al.Clinical and laboratory characteristics ofhyperprolactinemia in children and adolescents:Nationalsurvey. J. Clin. Res. Pediatr. 2019; 11(2).
- 11.Melmed S, Casanueva FF, Hoffman AR, et al.Diagnosis and treatment of hyperprolactinemia: anEndocrine Society clinical practice guideline. J.Pediatr. Endocrinol. Metab. 2011 ; 96(2):273–88.
- 12.Petersenn S, Fleseriu M, Casanueva FF, et al.Diagnosis and management of prolactin-secretingpituitary adenomas : a Pituitary Societyinternational Consensus Statement. Nat. Rev.Endocrinol. 2023;19(12):722–40.
- 13.Kontbay T, Şıklar Z, Özsu E et al.Hyperprolactinemia in children and adolescents andlong- term follow-upresults of prolactinomacases : asingle-centre experience. Turk. J. Pediatr.2022;:892–9.
- 14.Harrison JN, Cluxton-Keller F, Gross D.Antipsychotic medication prescribing trends inchildren and adolescents. J. Pediatr. HealthCare.2012 ; 26(2):139–45.
- 15.Rossow KM, Oshikoya KA, Aka IT, et al. Evidencefor pharmacogenomic effects on risperi-doneoutcomes in pediatrics. J Dev Behav Pediatr. 20214;42(3):205.
- 16.Chamnanphon M, Vanwong N, Prommas S, et al.Research in Autism Spectrum DisordersRisperidone plasma concentrations are associatedwith hyperprolactinemia in autism spectrumdisorderchildren : The impact of CYP2D6polymorphisms.Res Autism Spectr Disord. 2022; 96:102002.
- 17. Kalsi AK, Halder A, Jain M, Chaturvedi PK, SharmaJB. Prevalence and reproductive manifestations ofmacroprolactinemia. Endocrine. 2019;63(2):332–40.
- 18.Vilar L, Vilar F, Lyra R, Freitas C. Pitfalls in theDiagnostic Evaluation of Hyperprolactinemia.Neuroendocrinol. 2019;901:7–19.
Details
| Primary Language | Turkish |
|---|---|
| Subjects | Medical Education |
| Journal Section | Research Articles |
| Authors | |
| Publication Date | March 14, 2024 |
| Submission Date | January 3, 2024 |
| Acceptance Date | February 26, 2024 |
| Published in Issue | Year 2024 Volume: 50 Issue: 1 |
