1/2. Postburn galactorrhea with refractory hypertrophic scars: role of obesity under scrutiny.Postburn galactorrhea, although relatively uncommon, is a complex problem to treat. Three of 25 female premenopausal patients who were admitted during the years 1995 to 2001 with more than 40% TBSA burns developed this problem. All three patients were obese according to body mass index and other clinical criteria. It was observed that the additional disturbance of equilibrium of hypothalamus because of burn injury, which is already disturbed as per se in obese patients, precipitates sustained release of prolactin, leading to galactorrhea. Hyperinsulinemia because of obesity and associated reactive metabolic response of burn trauma contribute to the stimulation of prolactin secretion and sustained hyperprolactinemia. Interestingly, our patients who developed postburn galactorrhea also developed refractory hypertrophic scars not readily amenable to preventive and conservative therapeutic treatment methods. The responsible factor for its development can be a rise in prolactin levels with interplay of other hormones, such as melanocyte-stimulating hormone (MSH), from the anterior pituitary. Repeated serum prolactin measurements and early control of rising levels during the burn treatment, particularly in obese patients, are recommended. Early and vigorous measures to prevent scar hypertrophy also are advocated. In our study, we failed to correlate chest wall burns with galactorrhea.- - - - - - - - - - ranking = 1keywords = galactorrhea (Clic here for more details about this article) |
2/2. galactorrhea in a 12-year-old boy with a chromophobe adenoma.A 12-year-old with galactorrhea is presented. He was in early puberty, had gynecomastia, and was markedly obese. Roentgenograms of the skull showed an asymmetrically enlarged sella trucica, but pneumoencephalography did not indicate suprasellar extension of the pituitary tumor. Preoperative studies of anterior pituitary function were normal except for persistent hyperprolactinemia. By transsphenoidal approach, a microadenoma of the pituitary was removed. lactation ceased within a week, and four months postoperatively the patient had normal anterior pituitary function studies. A review of the literature indicates that galactorrhea in males is very rare. The most frequently documented cause, excluding drug ingestion, is a pituitary tumor.- - - - - - - - - - ranking = 0.25keywords = galactorrhea (Clic here for more details about this article) |