1/19. Anovulatory infertility: a report of four cases and literature review.Four cases of anovulatory/dysovulatory infertility encountered in Ilorin, nigeria are presented and the literature extensively reviewed on the up-to-date management of this aspect of infertility. All the patients had bilateral tubal patency on hysterosalpingography (HSG) and their husbands had normal seminal fluid analysis. The first case, 30 years of age, had hyperprolactinaemia with galactorrhoea, treated with bromocriptine given 2.5 mg twice daily. Another case, aged 27 years, had polycystic ovarian syndrome with hyperprolactinaemia but no galactorrhea This was treated with clomiphene citrate 100 mg daily. The third case, 34 years old, had hypothyroidism with hyperprolactinaemia and galactorrhea and was treated with thyroxine. The last case, aged 32 years, had hyperprolactinaemia and was treated with bromocriptine and clomiphene citrate. None of the patients had demonstrable pituitary adenoma. After the appropriate treatment, ovulatory menses were restored in all the patients; two have been pregnant, while the other two have not yet achieved pregnancy but have having regular ovulatory menses. All the patients are Nigerians.- - - - - - - - - - ranking = 1keywords = galactorrhea (Clic here for more details about this article) |
2/19. Empty sella developing during thyroxine therapy in a patient with primary hypothyroidism and hyperprolactinaemia.A 35 year old woman presented with severe primary hypothyroidism and galactorrhea. A very high prolactin level was also detected and computerized tomography scan of the sellar region demonstrated an enlarged pituitary gland associated with contrast enhancement. Replacement therapy with thyroxine corrected both biochemical and clinical abnormalities but empty sella developed during this therapy. It is concluded that empty sella may be related to thyroxine-induced shrinkage of lactotroph and/or thyrotroph cell hyperplasia.- - - - - - - - - - ranking = 0.5keywords = galactorrhea (Clic here for more details about this article) |
3/19. Primary amenorrhea-galactorrhea with hyperprolactinemia and huge pituitary enlargement in juvenile primary hypothyroidism.We report a girl with juvenile primary hypothyroidism revealed by growth retardation and a syndrome of primary amenorrhea-galactorrhea with hyperprolactinemia and suprasellar pituitary enlargement. Resolution of the pituitary enlargement and the amenorrhea-galactorrhea syndrome occurred after thyroid hormone replacement. No similar observation has been reported earlier in juvenile hypothyroidism.- - - - - - - - - - ranking = 3keywords = galactorrhea (Clic here for more details about this article) |
4/19. Pituitary enlargement in post-surgical hypothyroidism misdiagnosed as thyrotroph neoplasia. Report of a case.Primary hypothyroidism may be associated with enlargement of the sella turcica, due to thyrotroph hyperplasia, in its turn due to the lack of feedback control by thyroid hormones. It may develop independently of the severity or of the duration of thyroid failure. A 42-year-old woman was referred to us. She presented us with a CT scan compatible with a pituitary microadenoma, in the left part of the sella. The patient showed obvious signs of myxedema, due to subtotal thyroidectomy which had been performed 14 months before, because of the presence of multinodular goiter. After operation, the patient has been discontinuously and inappropriately treated with desiccated thyroid. She complained of headache, nausea, galactorrhea without amenorrhea. serum T4 (0.8 micrograms/dl), serum T3 (47 ng/dl) and TSH (174.5 /- 60.1 mU/l: M /- SD of 4 assays) were compatible with primary hypothyroidism as confirmed by TSH hyper-response to i.v. TRH (200 micrograms) and i.v. domperidone (10 mg), and by the normal TSH decrease after orally administered 2.5 mg bromocriptine or 90 min continuously infused 800 micrograms GHIRH. Moreover, an abnormal GH response to TRH was observed, whereas basal and appropriately stimulated PRL levels were normal. serum alpha-subunit was marginally high (5.92 ng/ml), but alpha-subunit/TSH molar ratio fell within the normal range (0.1 molar ratio). Complete suppression of basal and TRH stimulated TSH values was achieved after a 14-day L-T3 (120 micrograms per day) and 4-month L-T4 (200 micrograms per day) administration. L-T4 treatment, first administered at suppressive doses (200 micrograms per day for 4 months) and subsequently at substitutive doses (150 micrograms per day for 2 months), induced complete remission of symptoms along with normalization of the CT scan picture.- - - - - - - - - - ranking = 0.5keywords = galactorrhea (Clic here for more details about this article) |
5/19. patients with primary hypothyroidism presenting as prolactinomas.hyperprolactinemia can occur in patients with primary hypothyroidism. Two women with hypothyroidism who had elevated serum prolactin levels, galactorrhea, amenorrhea, and pituitary computed tomographic scans that demonstrated the presence of "pituitary tumors" were recently evaluated. It was believed that they had prolactinomas, and they were referred for possible surgery. An elevated serum thyroid-stimulating hormone level, however, suggested that they had primary hypothyroidism and probably pituitary enlargement secondary to pituitary hyperplasia. Detailed evaluation of thyroid-stimulating hormone and prolactin secretion was performed. These studies revealed several abnormalities in dopamine-prolactin interactions; however, the primary event responsible for the hyperprolactinemia is unclear. These women were given thyroxine therapy, and subsequent radiologic and endocrine studies documented resolution of their "pseudotumors" and normalization of the serum thyroxine and prolactin levels. Hence, thyroid-stimulating hormone levels should be measured in all patients presenting with a suspected prolactinoma so that any hypothyroidism that is noted is not presumed to be due to secondary hypothyroidism from tumor involvement of the pituitary.- - - - - - - - - - ranking = 0.5keywords = galactorrhea (Clic here for more details about this article) |
6/19. Primary amenorrhea and pseudoprolactinoma in a patient with primary hypothyroidism. Reversal of clinical, biochemical, and radiologic abnormalities with levothyroxine.A 15-year-old girl presented with primary amenorrhea, galactorrhea, hyperprolactinemia and an enlarged pituitary gland. She proved to have primary hypothyroidism. Therapy with levothyroxine resulted in prompt induction of regular menses, normalization of hormone levels, and a reduction in the size of the pituitary. Although hypothyroidism is known to produce secondary amenorrhea, hyperprolactinemia, and pituitary enlargement, this is believed to be the first computed tomographic documentation of such a "pseudoprolactinoma" presenting as primary amenorrhea.- - - - - - - - - - ranking = 0.5keywords = galactorrhea (Clic here for more details about this article) |
7/19. amenorrhea-galactorrhea due to occult hypothyroidism.A 25-year-old woman with galactorrhea, oligomenorrhea, hyperprolactinemia, and CT evidence of pituitary enlargement had transsphenoidal microsurgery with initial resolution of hyperprolactinemia, but persistent oligomenorrhea and galactorrhea. In retrospect, she had biochemical evidence of primary hypothyroidism before operation, despite being clinically euthyroid. Administration of thyroid hormone resulted in resolution of the pituitary enlargement and the symptoms.- - - - - - - - - - ranking = 3keywords = galactorrhea (Clic here for more details about this article) |
8/19. galactorrhea associated with primary hypothyroidism. Report of two cases.Two patients with primary hypothyroidism and galactorrhea are described. Elevated serum prolactin and thyroid-stimulating hormone levels were present. Following adequate thyroid hormone replacement restoration of clinical euthyroidism and cessation of galactorrhea occurred with a fall of both TSH and prolactin levels to normal.- - - - - - - - - - ranking = 1keywords = galactorrhea (Clic here for more details about this article) |
9/19. Clinical, biochemical, and radiologic reversibility of hyperprolactinemic galactorrhea-amenorrhea and abnormal sella by thyroxine in a patient with primary hypothyroidism.A case of primary hypothyroidism associated with postpartum galactorrhea-amenorrhea is reported. The configuration of the sella was compatible with pituitary adenoma, but prolactin dynamics did not support an autonomous secretory state. Replacement therapy with thyroxine led to complete reversal of clinical, radiologic, and biochemical abnormalities.- - - - - - - - - - ranking = 2.5keywords = galactorrhea (Clic here for more details about this article) |
10/19. Primary hypothyroidism, amenorrhea, and galactorrhea.A 30-year-old woman had galactorrhea and secondary amenorrhea, along with symptoms, signs, and laboratory findings of primary hypothyroidism. serum prolactin and thyrotropin (TSH) levels were elevated. After initiation of thyroid hormone replacement, serum TSH and prolactin levels fell progressively into the normal range. Along with these changes, the patient noted a return of normal menstrual function and the galactorrhea disappeared.- - - - - - - - - - ranking = 3keywords = galactorrhea (Clic here for more details about this article) |
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