Medical therapy of XXXX in males: I. Prevalence of @entity4614 at diagnosis. II. Proportion of cases exhibiting recovery of pituitary function.

@entity1 @entity4089 @entity251 @entity1375 @entity2013 @entity227 @entity935 @entity5 @entity16054 @entity4614 @entity701 @entity6126 @entity2270
@entity4089 frequently causes secondary @entity6126 through central suppression of gonadotropin secretion. @entity2013 (> 1 cm diameter) are more common in males and may additionally cause more generalised @entity4614 . Recovery of the thyrotropic and/or corticotropic axes is well described following selective adenomectomy, but remains poorly defined in relation to medical ( @entity935 -agonist) therapy of @entity2013 . We therefore performed a retrospective examination of case records of male @entity1 who had received medical therapy alone for macroprolactinoma between 1980-2001 (n = 35) and in whom @entity5 shrinkage was documented by interval pituitary imaging (reported throughout by a single neuroradiologist). Mean prolactin level at baseline was 59,932 mU/L (median 31,400; range 3,215-332,000); mean period of follow up was 4.2 years (median 2.6; range: 1.0-15). Defects of the following axes were evident at diagnosis: LH/FSH- @entity251 (n = 27; 77%), TSH-T4 (n = 14; 41%-not including one case with pre-existing 1 @entity1375 ), ACTH- @entity701 (n = 8; 23%). Overall, 14 @entity1 (40%) were @entity2270 , seven (20%) in 2 axes and seven (20%) in 3 axes. Growth hormone secretory status was not systematically evaluated. In all but 6 @entity1 , prolactin levels fell to normal or near-normal levels (mean 764 mU/L; median 260; range: < 10-4,833). Of the @entity1 in whom adequate reassessment had been performed, thyrotroph function recovered in 4/9, corticotroph function in 4/6 and gonadotroph function in 16/26 cases. In four cases (11%) previously described, development of @entity227 as a result of the chiasmal traction syndrome necessitated a dose reduction in medical therapy to allow a degree of controlled @entity5 re-expansion. The prevalence at diagnosis of TSH and @entity16054 in @entity1 with @entity2013 was 41% and 23%, respectively. Among eight @entity1 with insufficiency of TSH and/or ACTH secretion who underwent complete interval reassessment over several years of treatment, recovery of at least one @entity2270 occurred in six cases (75%). This study highlights the importance of screening ACTH- and/or TSH-deficient @entity1 during @entity935 agonist therapy in order to identify cases where @entity4614 has resolved.
