卡麦角林治疗后的微泌乳素瘤中风:情况罕见但十分紧急

Hamza El Jadi, Zakaria Toufga, Imane Moustaghit
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摘要

垂体性脑瘫(PA)是一种罕见的临床症状,由伴有或不伴有出血的垂体梗死引起。虽然它通常是自发性的,但多巴胺能激动剂(DA)是已知的易感因素,尤其是溴隐亭,卡麦角林更为罕见。我们报告了一例 31 岁的微泌乳素瘤患者的病例,该患者在服用卡贝戈林 5 个月后因垂体性视力减退而出现急性视力下降。其后,患者的视力状况明显好转。垂体性视力减退是一种罕见的情况。常有报告称使用溴隐亭时会出现垂体功能障碍,但使用卡麦角林时也会出现垂体功能障碍。由于垂体性脑瘫的死亡率和发病率都很高,因此在使用 DA 进行治疗时,有必要进行密切监测,并告知患者这种风险。虽然 DA 会诱发风险,但可以继续治疗以获得激素和抗肿瘤缓解。
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Apoplexy of Microprolactinoma after Cabergoline Therapy: Rare Situation but Big Emergency
Pituitary apoplexy (PA) is a rare clinical situation caused by pituitary infarction with or without haemorrhage. Although it is usually spontaneous, dopaminergic agonists (DA) are known to be predisposing factors, particularly Bromocriptine, more rarely Cabergoline. We report the case of a 31-years-old patient with a microprolactinoma who developed acute visual acuity loss due to pituitary apoplexy 5 months after taking Cabergoline. The evolution was marked by a considerable improvement of the visual state. Pituitary apoplexy is a rare situation. Often reported with Bromocriptine, PA can also occur with Cabergoline. Due to the high mortality and morbidity of apoplexy, it should be borne in mind that close monitoring is necessary when treatment with DA is prescribed and the patient should be informed of this risk. Although DA precipitate risk, treatment can be continued for hormonal and anti-tumour remission.
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