AIM: Prolactinoma is a pituitary adenoma that secretes prolactin. Approximately 40% of all pituitary adenomas are prolactinomas. According to size, they are divided into micro, macro and giant prolactinomas. In women, prolactinomas cause irregularities of the menstrual cycle such as amenorrhea, galactorrhea, weight gain, in both sexes they cause sterility, hypogonadism, decreased libido and depression. In macroadenomas, symptoms due to the compression of the surrounding structures are also manifested, such as headache, vomiting, lower chiasmatic syndrome and ophthalmoplegia. Loss of the visual field due to compression of the optic chiasm is caused by a tumor larger than 10-15 mm with suprasellar spreading, which breaks through the diaphragma sellae. Giant prolactinomas are larger than 40 mm and make up 1-5% of all prolactinomas. CASE REPORT: In this article I present the case of a 38-year-old woman from Ukraine with advanced chiasmatic syndrome caused by a giant prolactinoma. The tumor is infiltrating the left cavernous sinus, causing left-sided amaurosis and right-sided temporal hemianopsia. CONCLUSION: Inferior chiasmatic syndrome is characterized by bitemporal hemianopsia, a deterioration of visual acuity, bilateral bow-tie descendent atrophy of the optic nerve disc, and hemianopic rigidity of the pupils. Macroprolactinomas occur more frequently in men than in women. The diagnosis is often delayed, probably because the symptoms of hyperprolactinemia are less obvious in men, while women tend to present earlier due to menstrual cycle irregularities. Prolactinomas usually have a good prognosis. Effective medical treatment with dopamine agonists is available. Knowledge of the prolactinoma symptoms could help the diagnosis of compressive lesions of the optic chiasm.

• Klíčová slova
• Pituitary gland, bitemporal hemianopsia, hyperprolactinemia, prolactinoma,
• MeSH
• agonisté dopaminu MeSH
• dospělí MeSH
• hyperprolaktinemie * diagnóza   etiologie   terapie   MeSH
• lidé MeSH
• nádory hypofýzy * komplikace   diagnóza   terapie   MeSH
• prolaktin MeSH
• prolaktinom * komplikace   diagnóza   patologie   MeSH
• těhotenství MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• mužské pohlaví MeSH
• těhotenství MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• kazuistiky MeSH
• Názvy látek
• agonisté dopaminu MeSH
• prolaktin MeSH

Sexual dysfunctions in men are complex disorders that consist of organic and psychogenic components. The most common sexual dysfunction is erectile dysfunction. It is the inability to achieve or maintain an erection for satisfactory sexual performance. This disorder can be caused by high blood pressure, heart disease, vascular problems, psychological and hormonal factors such as problems with testosterone and prolactin levels. In this study, we tested the relationship between erectile dysfunction, hyperprolactinemia and psychosocial stress. Clinical examinations of 60 patients with erectile dysfunction, which also included psychosocial stress, focussed on patient history, comprehensive sexological examination, biochemical analyses of serum prolactin, total testosterone and thyroid-stimulating hormone with psychometric evaluation of erectile function and a checklist of trauma symptoms (TSC-40). The results show significant Spearman correlations of psychometric evaluation of erectile function with prolactin (R = .50) and results of the trauma checklist score (R = .55) and significant Spearman correlations between TSC-40 and prolactin (R = .52). This result indicates a significant relationship between erectile dysfunction, hyperprolactinemia and stress symptoms in men.

• Klíčová slova
• erectile dysfunction, hyperprolactinemia, international index of erectile function questionnaire, psychosocial stress,
• MeSH
• erekce penisu MeSH
• erektilní dysfunkce * etiologie   MeSH
• hyperprolaktinemie * komplikace   MeSH
• lidé MeSH
• prolaktin MeSH
• psychický stres komplikace   MeSH
• testosteron MeSH
• Check Tag
• lidé MeSH
• mužské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• Názvy látek
• prolaktin MeSH
• testosteron MeSH

Adverse effect of dopamine agonists on the heart valves aroused much attention some time ago. Gradually, as data accumulated, the approach to the problem was rationalised and further examinations were only recommended in indicated cases. The paper reviews the current knowledge about the treatment of hyperprolactinemia with dopamine agonists and the risk of valvular disease.Key words: dopamine agonists - ergolines/adverse effects - heart valve diseases - hyperprolactinemia - pituitary neoplasms - prolactinoma.

• MeSH
• agonisté dopaminu terapeutické užití   MeSH
• ergoliny terapeutické užití   MeSH
• hyperprolaktinemie farmakoterapie   MeSH
• lidé MeSH
• nemoci srdečních chlopní chemicky indukované   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• přehledy MeSH
• Názvy látek
• agonisté dopaminu MeSH
• ergoliny MeSH

Pituitary hormone and cytokine prolactin (PRL) is one of the mediators of the bidirectional communication between neuroendocrine and immune systems. It participates in many immunomodulatory activities, affects differentiation and maturation of both, B and T lymphocytes and enhances inflammatory responses and production of immunoglobulins. Hyperprolactinemia has been described in many autoimmune diseases, both systemic (SLE, RA, PsA) and organ-specific (T1D, CD and others) and the activity of PRL has been intensively studied. Nevertheless, no data on PRL contribution to pathogenesis of diabetes mellitus is available, although the effect of PRL on beta cells of the pancreas and insulin secretion has been observed.

• MeSH
• B-lymfocyty imunologie   metabolismus   patologie   MeSH
• beta-buňky imunologie   metabolismus   patologie   MeSH
• buněčná diferenciace MeSH
• diabetes mellitus imunologie   metabolismus   MeSH
• hyperprolaktinemie metabolismus   MeSH
• inzulin metabolismus   MeSH
• lidé MeSH
• mediátory zánětu imunologie   metabolismus   MeSH
• neuroimunomodulace * MeSH
• prolaktin imunologie   metabolismus   MeSH
• protilátky imunologie   metabolismus   MeSH
• sekrece inzulinu MeSH
• T-lymfocyty imunologie   metabolismus   patologie   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• přehledy MeSH
• Názvy látek
• inzulin MeSH
• mediátory zánětu MeSH
• prolaktin MeSH
• protilátky MeSH

OBJECTIVES: The main objective was to evaluate the effect of five second-generation antipsychotics (amisulpride, quetiapine, olanzapine, risperidone, and zotepine) on prolactinaemia during 6 week therapy in 433 female in-patients with mainly schizophrenic disorders. Secondary objectives included identification of dynamics of change in serum prolactin levels and correlations of changes of prolactinaemia with some demographic and clinical parameters. METHODS: The trial was a prospective, open-label, single-center one with a flexible dosing of SGAs. The therapeutic effect of SGAs was assessed by a change of scores of CGI-S and CGI-I scales from a baseline to the endpoint. Blood samples were taken in the morning under fasting condition. RESULTS: Amisulpride and risperidone increased prolactinaemia significantly in 100% of patients, as early as after week 1 of the therapy. Quetiapine and zotepine relatively reduced prolactinaemia significantly, as early as from week 1 of the quetiapine treatment. Olanzapine led to a transient mild prolactin elevation. The much lower prevalence of hyperprolactinaemia over 2 000 mIU/l differentiates olanzapine from amisulpride and risperidone. Prolactin elevation did not correlate with age, menopausal condition, therapeutic efficacy, antipsychotic daily dose, serum levels of lipids and glucose. There was significant correlation with first vs. subsequent psychotic episodes, weight, EPS and serum levels of thyroid hormones. CONCLUSION: Amisulpride and risperidone had marked and early prolactin elevating effects, requiring, therefore, more frequent monitoring of prolactinaemia and associated undesirable effects and risks than olanzapine, quetiapine and zotepine.

• MeSH
• amisulprid MeSH
• antipsychotika škodlivé účinky   terapeutické užití   MeSH
• benzodiazepiny škodlivé účinky   terapeutické užití   MeSH
• dibenzothiazepiny škodlivé účinky   terapeutické užití   MeSH
• dibenzothiepiny škodlivé účinky   terapeutické užití   MeSH
• dospělí MeSH
• hyperprolaktinemie krev   chemicky indukované   MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladiství MeSH
• neparametrická statistika MeSH
• olanzapin MeSH
• prolaktin krev   MeSH
• prospektivní studie MeSH
• quetiapin fumarát MeSH
• risperidon škodlivé účinky   terapeutické užití   MeSH
• schizofrenie komplikace   farmakoterapie   MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• sulpirid škodlivé účinky   analogy a deriváty   terapeutické užití   MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladiství MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• klinické zkoušky MeSH
• práce podpořená grantem MeSH
• srovnávací studie MeSH
• Názvy látek
• amisulprid MeSH
• antipsychotika MeSH
• benzodiazepiny MeSH
• dibenzothiazepiny MeSH
• dibenzothiepiny MeSH
• olanzapin MeSH
• prolaktin MeSH
• quetiapin fumarát MeSH
• risperidon MeSH
• sulpirid MeSH
• zotepine MeSH Prohlížeč

OBJECTIVE: Risperidone in antipsychotic doses induces hyperprolactinemia. The aim of this study was to verify whether the same is true for low doses of risperidone (0.5-2 mg per day) added to antidepressants or anxiolytics. METHODS: Prolactin levels were measured in 4 men (mean age 49.5+/-19.1 years) and 8 women (mean age 31.3+/-8.2 years) inpatients with depressive and anxiety disorders who were treated with risperidone (median doses per day 1.25 mg) for median 15.5 days as an augmentation treatment to antidepressants (n=8), anxiolytics (n=6) and mood stabilizers (n=2). RESULTS: 11 of 12 patients had hyperprolactinemia. Median plasma prolactin level was 1598 mIU/ml, 95% CI 1 040-2 661 mIU/ml. Significant correlation between risperidone daily dose and plasma prolactin level (Spearman's R=0.655, p=0.02) was detected. Two women suffered from galactorrhea and one from amenorrhea. CONCLUSIONS: Even low doses of risperidone used as an augmentation to antidepressants or benzodiazepines are associated with hyperprolactinemia and can induce endocrinological side effects. The co-medication of antidepressants and benzodiazepines can potentially increase intensity of prolactinemia.

• MeSH
• antidepresiva aplikace a dávkování   terapeutické užití   MeSH
• antipsychotika aplikace a dávkování   škodlivé účinky   MeSH
• anxiolytika aplikace a dávkování   terapeutické užití   MeSH
• benzodiazepiny aplikace a dávkování   terapeutické užití   MeSH
• depresivní poruchy krev   farmakoterapie   MeSH
• dospělí MeSH
• hyperprolaktinemie chemicky indukované   MeSH
• kombinovaná farmakoterapie MeSH
• lidé středního věku MeSH
• lidé MeSH
• neparametrická statistika MeSH
• prolaktin krev   MeSH
• risperidon aplikace a dávkování   škodlivé účinky   MeSH
• úzkost krev   farmakoterapie   MeSH
• vztah mezi dávkou a účinkem léčiva MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• klinické zkoušky MeSH
• práce podpořená grantem MeSH
• Názvy látek
• antidepresiva MeSH
• antipsychotika MeSH
• anxiolytika MeSH
• benzodiazepiny MeSH
• prolaktin MeSH
• risperidon MeSH

OBJECTIVES: Amisulpride in antipsychotic doses can induce hyperprolactinemia. The aim of this study was to prove whether the same is true for low doses of amisulpride. METHODOLOGY: Plasma prolactin levels were measured in 5 males and 5 females with depressive symptoms who were treated with 50 mg of amisulpride per day as an augmentation to antidepressants (n=5), benzodiazepine anxiolytics (n=8) or in monotherapy (n=1). Six of these patients were assessed prior to onset of amisulpride treatment and after 10 days of amisulpride use. Four patients had been using amisulpride for more than a month. RESULTS: There was a significant increase of prolactin levels from mean 16+/-6 ng/ml to 113+/-65 ng/ml (median 14.5 ng/ml to median 92 ng/ml; Wilcoxon matched pair test, p=0.027). All patients had hyperprolactinemia (30-200 ng/ml). The prolactinemia was significantly higher in females (mean 160+/-50 ng/ml; median 198 ng/ml) than in males (mean 48+/-12 ng/ml; median 48 ng/ml; Mann-Whitney U test, p=0.041). CONCLUSION: Even low doses of amisulpride used as an augmentation to antidepressant treatment, benzodiazepines or in monotherapy seem to be associated with hyperprolactinemia. The co-medication of antidepressants and benzodiazepines can potentially increase intensity of prolactinemia.

• MeSH
• amisulprid MeSH
• antidepresiva aplikace a dávkování   MeSH
• antipsychotika aplikace a dávkování   škodlivé účinky   MeSH
• anxiolytika aplikace a dávkování   MeSH
• deprese farmakoterapie   MeSH
• dospělí MeSH
• hyperprolaktinemie krev   chemicky indukované   MeSH
• kombinovaná farmakoterapie MeSH
• lidé středního věku MeSH
• lidé MeSH
• prolaktin krev   MeSH
• sulpirid aplikace a dávkování   škodlivé účinky   analogy a deriváty   MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• klinické zkoušky MeSH
• práce podpořená grantem MeSH
• Názvy látek
• amisulprid MeSH
• antidepresiva MeSH
• antipsychotika MeSH
• anxiolytika MeSH
• prolaktin MeSH
• sulpirid MeSH

The results of a study of effects of stress on serum prolactin (PRL) levels in patients with SLE reveal statistically significant differences in serum PRL level readings in samples taken over a short period of time, thus corroborating the need to take into account PRL stress induction during sample withdrawals and to interpret the values obtained, especially where moderate idiopathic hyperprolactinemia was detected. To eliminate any external stress factors, it is advisable to take PRL samples repeatedly and in perfectly resting patients.

• MeSH
• adenohypofýza metabolismus   MeSH
• autoimunitní nemoci krev   komplikace   patofyziologie   MeSH
• bolest etiologie   patofyziologie   MeSH
• časové faktory MeSH
• dospělí MeSH
• flebotomie škodlivé účinky   psychologie   MeSH
• fyziologický stres etiologie   patofyziologie   MeSH
• hyperprolaktinemie etiologie   patofyziologie   MeSH
• lidé středního věku MeSH
• lidé MeSH
• periferní katetrizace škodlivé účinky   psychologie   MeSH
• prolaktin krev   metabolismus   MeSH
• psychický stres etiologie   patofyziologie   MeSH
• rychlost sekrece MeSH
• systémový lupus erythematodes krev   komplikace   patofyziologie   MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Názvy látek
• prolaktin MeSH

OBJECTIVE: To verify the presence of hyper-PRL in SLE patients, its association with high disease activity, specific organ involvement or presence of anti-ds-DNA antibodies. METHODS: The group under study consisted of 80 patients with systemic lupus erythematosus (SLE), 28 patients with rheumatoid arthritis (RA) and 27 healthy controls. PRL serum levels were assayed using standard commercial kits (Immunotech Prague) with the radioimmunometric method for testing three samples of each of the subjects. The samples were taken in the morning hours (9-11 a.m.) of absolute rest 30 minutes after the introduction of the cannula at 30-minute intervals. RESULTS: A significantly higher rate of elevated PRL levels was found in SLE patients (40.0%) compared with the healthy controls (14.8%, p < 0.017). No proof was found of association with the presence of anti-ds-DNA or with specific organ involvement. Similarly, elevated PRL levels were found in RA patients (39.3%). The PRL elevation tended to decline from the 1st to the 3rd sample in the group of patients with SLE and RA but not in healthy controls. CONCLUSION: As follows from our measurements of prolactin serum values in SLE patients they are varriable by definition. According to our opinion further investigations are needed.

• MeSH
• dospělí MeSH
• hyperprolaktinemie krev   etiologie   MeSH
• lidé středního věku MeSH
• lidé MeSH
• prolaktin krev   MeSH
• reagenční diagnostické soupravy MeSH
• revmatoidní artritida krev   komplikace   MeSH
• systémový lupus erythematodes krev   komplikace   MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Názvy látek
• prolaktin MeSH
• reagenční diagnostické soupravy MeSH

Magnetic resonance imaging is a method of choice for the diagnosis of microprolactinomas. Using a Phillips Gyroscan NT 15 (1.5 T), 42 patients whose clinical history and serum prolactin levels were compatible with the diagnosis of prolactinomas were examined. Four patients (3 male and 1 female) with macroadenoma were investigated and excluded, while microprolactinoma was found in the other 38 (32 female and 6 male) patients. Imaging features were similar in all microprolactinomas--hypointensity up to 10 mm in size in T1 weighted images, only sometimes, in the case of a cystic or a hemorrhagic component, also registered in T2 weighted images. Deviation of the pituitary stalk was present in 19 of the 38 patients (16 with microprolactinoma, 3 without any detectable lesion). Convex upper limit of the gland was demonstrated in 17 subjects (16 microprolactinomas, 1 without detectable lesion). Pituitary adenoma is not the only cause of raised serum prolactin level. This can be a consequence of medication, spinal cord tumor, compression of the pituitary stalk, hypothyroidism or a lesion in dermatomes T3 to T5 (mammary gland level). Results from imaging must always be assessed in the light of the patient's clinical history and biochemical parameters.

• MeSH
• adenom diagnóza   MeSH
• diferenciální diagnóza MeSH
• hyperprolaktinemie krev   etiologie   MeSH
• lidé MeSH
• magnetická rezonanční tomografie * metody   MeSH
• nádory hypofýzy krev   diagnóza   patologie   MeSH
• prolaktin krev   MeSH
• prolaktinom krev   diagnóza   patologie   MeSH
• Check Tag
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Názvy látek
• prolaktin MeSH