Cesario F, Borretta G, Meineri I, Muratori M, Pizzocaro A, Beck-Peccoz P
Divisione di Endocrinologia Ospedale S. Croce, Cuneo, Italy.
J Pediatr Endocrinol Metab. 1997 Mar-Apr;10(2):231-6. doi: 10.1515/jpem.1997.10.2.231.
The rare macroprolactinomas seen in childhood frequently cause delayed puberty and GH deficiency. We report the combined use of cabergoline and recombinant human GH (rhGH) therapy in a male adolescent with macroprolactinoma and GH deficiency. Computed tomography and magnetic resonance imaging of the hypothalamic-pituitary region showed a macroadenoma with extrasellar extension. Neither bromocriptine nor dihydroergocryptine therapy was successful in decreasing serum PRL levels. On cabergoline treatment normal serum PRL levels were achieved within 3 months along with a marked shrinkage of the adenoma but growth rate did not increase nor did puberty start. The addition of exogenous rhGH therapy improved the growth rate, but complete pubertal development was obtained only after the administration of exogenous gonadotropins. During the combined treatment no expansion of the macroadenoma was observed. In conclusion, the combined therapy with cabergoline and rhGH seems to be safe and highly effective. Nevertheless, it warrants careful monitoring and on-going evaluation.
儿童期罕见的大泌乳素瘤常导致青春期发育延迟和生长激素缺乏。我们报告了卡麦角林和重组人生长激素（rhGH）联合治疗一名患有大泌乳素瘤和生长激素缺乏的男性青少年的情况。下丘脑 - 垂体区域的计算机断层扫描和磁共振成像显示有一个向鞍外扩展的大腺瘤。溴隐亭和二氢麦角隐亭治疗均未能成功降低血清泌乳素水平。接受卡麦角林治疗3个月内血清泌乳素水平恢复正常，腺瘤明显缩小，但生长速度未增加，青春期也未启动。添加外源性rhGH治疗提高了生长速度，但仅在给予外源性促性腺激素后才实现完全的青春期发育。联合治疗期间未观察到垂体大腺瘤增大。总之，卡麦角林和rhGH联合治疗似乎安全且高效。然而，仍需仔细监测和持续评估。
