Prolaktinomalı hastalarda klinik ve laboratuvar özelliklerin retrospektif değerlendirilmesi
Küçük Resim Yok
Tarih
2018
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Trakya Üniversitesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Günümüzde en sık görülen hipofiz tümörleri prolaktinomalardır. Klinik olarak hiperprolaktinemiye ve kitle etkisine bağlı semptomlar görülür. Hiperprolaktineminin en sık görülen sebebi prolaktinomadır. Prolaktinoma tanısı için hiperprolaktineminin prolaktinoma dışı sebeplerinin (fizyolojik, farmakolojik ve patolojik) ayırt edilmesi gerekir. Tedavisinde cerrahi, radyoterapi ve medikal tedavi kullanılmaktadır. Medikal tedavide öncelikli olarak dopamin reseptör agonistleri kullanılmaktadır. Bu çalışmada; prolaktinoma tanısı ile takip ve tedavi edilen hastaların demografik özellikleri ile klinik takip ve tedavi süreçlerindeki değişimlerin incelenmesi amaçlanmıştır. 1998-2016 yılları arasında Trakya Üniversitesi İç Hastalıkları Ana Bilim Dalı Endokrinoloji ve Metabolizma Hastalıkları poliklinik ve servisinde prolaktinoma tanısı ile takip edilen hastalar retrospektif olarak tarandı. 18 yaşından küçük olan, ilaca bağlı ve gebeliğe bağlı hiperprolaktinemisi olan hastalar dışlanarak 151 hasta çalışmaya dahil edildi. Hastalara ait demografik özellikler, başvuru şikayetleri ve klinik bulguları, laboratuar değerleri, adenom boyutları ve görme alanı bulguları incelendi. Medikal tedavi altındaki hastalardan 1.yılın sonunda medikal tedavisi kesilmiş olanlar, medikal tedavi yanıtlı; 1.yılın sonunda medikal tedavi kesilememiş olan hastalarsa, medikal tedavi yanıtsız olarak gruplandırıldı. Her iki grup içinde yukarıdaki özellikler karşılaştırmalı olarak değerlendirildi. İstatistiksel çalışmada tanımlayıcı istatistik, ki-kare, T-testi, bonferroni, lineer regresyon kullanıldı. Medikal tedaviye yanıtına göre kıyaslandığında olguların başvuru şikayetleri ve klinik bulguların görülme sıklığı açısından herhangi bir fark saptanmadı. Medikal tedaviye yanıt ve adenom boyutuna göre prolaktin düzeyleri kıyaslandığında medikal tedaviye yanıtsız makroprolaktinomalı olgularda ortalama prolaktin düzeyleri daha yüksek saptandı. İki yıllık medikal tedavi sonrasında gonadotropik aks bozukluğu saptanan hasta sayısı belirgin şekilde azaldı. Anahtar Kelimeler: Prolaktinoma, hiperprolaktinemi, mikroprolaktinoma
Today, the most common pituitary tumors are prolactinomas. Clinically there are symptoms associated with hyperprolactinemia and mass effect. The most common cause of hyperprolactinemia is prolactinoma. For the diagnosis of prolactinomas, hyperprolactinemia should be distinguished from non-prolactinomas (physiological, pharmacological and pathological). Surgery, radiotherapy and medical treatment are used in the treatment. In medical therapy, dopamine receptor agonists are primarily used. The aim of this study was to investigate the demographic characteristics of patients followed and treated with prolactinoma diagnosis and the changes in clinical follow-up and treatment processes. Patients who were followed-up with prolactinoma diagnosis in Department of Endocrinology and Metabolism Diseases of Trakya University Internal Medicine Department between 1998-2016 were retrospectively screened. 151 patients who were elder than 18 years of age, were admitted to the study with the exception of patients who were adherent and had gestational hyperprolactinemia. Demographic characteristics, admission complaints and clinical findings, laboratory values, adenomal dimensions and visual field findings of the patients were analyzed. Medical treatment patients who were discontinued medical treatment at the end of the 1st year is classified medical treatment responders. Medical treatment continued patients at the end of the 1st year were classified as unresponsive. The above features were evaluated comparatively in both groups. In the statistical study, descriptive statistics, Chi-square, T-test, Bonferroni, linear regression were used. When compared with medical treatment response, there was no difference in terms of frequency of admission complaints and clinical findings. When prolactin levels were compared according to medical treatment response and adenoma size, mean prolactin levels were higher in macroprolactinoma cases with unresponsive to medical treatment. After 2 years of medical treatment, the number of patients who had gonadotropic axis disorder was significantly reduced. Key words: Prolactinoma, hyperprolactinemia, microprolactinoma
Today, the most common pituitary tumors are prolactinomas. Clinically there are symptoms associated with hyperprolactinemia and mass effect. The most common cause of hyperprolactinemia is prolactinoma. For the diagnosis of prolactinomas, hyperprolactinemia should be distinguished from non-prolactinomas (physiological, pharmacological and pathological). Surgery, radiotherapy and medical treatment are used in the treatment. In medical therapy, dopamine receptor agonists are primarily used. The aim of this study was to investigate the demographic characteristics of patients followed and treated with prolactinoma diagnosis and the changes in clinical follow-up and treatment processes. Patients who were followed-up with prolactinoma diagnosis in Department of Endocrinology and Metabolism Diseases of Trakya University Internal Medicine Department between 1998-2016 were retrospectively screened. 151 patients who were elder than 18 years of age, were admitted to the study with the exception of patients who were adherent and had gestational hyperprolactinemia. Demographic characteristics, admission complaints and clinical findings, laboratory values, adenomal dimensions and visual field findings of the patients were analyzed. Medical treatment patients who were discontinued medical treatment at the end of the 1st year is classified medical treatment responders. Medical treatment continued patients at the end of the 1st year were classified as unresponsive. The above features were evaluated comparatively in both groups. In the statistical study, descriptive statistics, Chi-square, T-test, Bonferroni, linear regression were used. When compared with medical treatment response, there was no difference in terms of frequency of admission complaints and clinical findings. When prolactin levels were compared according to medical treatment response and adenoma size, mean prolactin levels were higher in macroprolactinoma cases with unresponsive to medical treatment. After 2 years of medical treatment, the number of patients who had gonadotropic axis disorder was significantly reduced. Key words: Prolactinoma, hyperprolactinemia, microprolactinoma
Açıklama
Tıpta Uzmanlık
Anahtar Kelimeler
Endokrinoloji ve Metabolizma Hastalıkları, Endocrinology and Metabolic Diseases
