泌乳素瘤所致病态肥胖及多巴胺激动剂治疗后的显著体重减轻
Morbid Obesity Due to Prolactinoma and Significant Weight Loss After Dopamine Agonist Treatment.
作者信息
Ali Muzaffar, Mirza Lubna
机构信息
Department of Internal Medicine, Rehman Medical Institute, Peshawar, Pakistan.
Department of Endocrinology, Norman Regional Hospital, Oklahoma.
出版信息
AACE Clin Case Rep. 2021 Mar 11;7(3):204-206. doi: 10.1016/j.aace.2021.01.004. eCollection 2021 May-Jun.
OBJECTIVE
Morbid obesity may be related to a prolactinoma, although uncommon, and can lead to adverse effects like insulin resistance and metabolic syndrome. Recent research suggests that hyperprolactinemia causes an abnormal lipid profile, weight gain, and cardiovascular diseases. Moreover, high prolactin levels lead to decreased testosterone production by disrupting 17-b-estradiol synthesis. Our objective was to present a case of prolactinoma with morbid obesity, hypogonadism, and then significant weight loss after dopamine agonist treatment.
METHODS
The clinical course, in addition to serial laboratory and imaging results, are presented. These include prolactin levels, testosterone levels, thyroid function tests, blood sugar levels, and serial lipid profiles.
RESULTS
In this report, we discuss a case of 30-year-old male with prolactin-secreting macroadenoma with clinical features of hypogonadism, hypothyroidism, and morbid obesity. He showed marked improvement in obesity and hypogonadism with dopamine agonist therapy supplemented with clomiphene citrate.
CONCLUSION
Prolactinomas with morbid obesity can be successfully treated contingent upon proper medication and compliance with medications. Insulin resistance, hypogonadism, prolactin levels, body mass index, and tumor size all improved by regular follow-up and treatment adherence.
目的
病态肥胖可能与泌乳素瘤有关，尽管并不常见，且可导致胰岛素抵抗和代谢综合征等不良反应。近期研究表明，高泌乳素血症会导致脂质谱异常、体重增加和心血管疾病。此外，高泌乳素水平会通过干扰17-β-雌二醇的合成导致睾酮生成减少。我们的目的是报告一例患有病态肥胖、性腺功能减退的泌乳素瘤患者，经多巴胺激动剂治疗后体重显著减轻。
方法
介绍了该患者的临床病程以及系列实验室和影像学检查结果。这些检查包括泌乳素水平、睾酮水平、甲状腺功能检查、血糖水平和系列脂质谱。
结果
在本报告中，我们讨论了一例30岁男性泌乳素分泌型大腺瘤患者，其具有性腺功能减退、甲状腺功能减退和病态肥胖的临床特征。在多巴胺激动剂治疗并辅以枸橼酸氯米芬后，他的肥胖和性腺功能减退症状有了显著改善。
结论
患有病态肥胖的泌乳素瘤患者可以通过适当用药并坚持服药而得到成功治疗。通过定期随访和坚持治疗，胰岛素抵抗、性腺功能减退、泌乳素水平、体重指数和肿瘤大小均得到改善。
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