Serum growth hormone and ultrastructural studies of adenohypophysial tissue in bromocriptine treated acromegalic patients.

The therapeutic effectiveness of bromocriptine as well as the post-operative ultrastructural aspects of treated pituitary adenomas were investigated in five acromegalic patients. Although concentrations of GH basal decreased and the glucose tolerance test and the TSH responses were significantly improved, the release of GH induced by TRH was not prevented by the dopaminergic agonist. Adenomatous cells were densely granulated and contained a dilated endoplasmic reticulum. Misplaced exocytosis was frequently observed. These findings clearly indicate that bromocriptine inhibits the spontaneous release of GH but does not interfere with the abnormal GH response to TRH. This suggests a separate site of action. The drug seems not to block the synthesizing activity of the adenomatous cell, a finding in accordance with clinical observations that warns against its use as a single therapeutic agent.