International Medical Journal, Vol. 20., Iss. 3, 2014, P. 39−44.
Clinical pattern of neurological manifestations of pituitary microprolactinomas in women of reproductive age
S. I. Georgievsky Crimean State Medical University, Simferopol, Ukraine
Microprolactinoma is the most common functioning pituitary adenoma. In the chain of pathogenic events developing during microprolactinoma functioning hyperprolactinemia is a key element. Hyperprolactinemia triggers a number of neuroendocrine changes, which clinically manifest by menstrual and, subsequently, reproductive functions; pathological changes in the breast with development of galactorrhea; endocrine disorders in the form of androgeny of andrenal origin, thyroid disorders, hyperinsulinemia, osteoporosis, ocular changes. Undeservedly little attention has been paid to neurological and psychoaffective disorders, which, according to our observations, occur under the described syndrome in more than a half of cases. Pathogenetic aspects of development of these disorders are not clear. We analyzed 52 cases of pituitary microprolactinomas in female patients of reproductive age. Clinical performance of neurological manifestations in this group of patients, depending on the extent of the defect was also analyzed. It was shown that the described complex of disorders was often obligate for female patients of reproductive age with pituitary microprolactinomas and it can present without references to concomitant gynecological signs, which require an interview in order to determine ovarian menstrual cycle disorders as a clinical criterion of hormonal state disorder in female patients of the group. This can ensure early diagnosis and timely initiation of pathogenetic therapy, which largely reduces these symptoms.
Key words: pituitary miсroprolactinoma, prolactin, hormonal status, neurologic manifestations.