SeminarGrowth-hormone and prolactin excess
Section snippets
Epidemiology
The prevalence of GH-secreting adenomas is 50–80 cases per million, and the incidence is three to four new cases per million per year.1, 2 In less than 2% of patients, excessive GH secretion may be the consequence of a hypothalamic or ectopic tumour (gangliocytoma, bronchial, or pancreatic) that produces GH-releasing hormone (GHRH); such tumours lead to somatotroph hyperplasia or a well-defined adenoma. The ectopic secretion of GH itself is even rarer.1
Diagnosis
The clinical features of acromegaly
Epidemiology
The aetiology of pathological hyperprolactinaemia is diverse (panel). Any process interfering with dopamine synthesis, its transport to the pituitary gland, or its action at lactotroph dopamine receptors can lead to hyperprolactinaemia.3 Once drugs are excluded, microprolactinomas (<10 mm) or macroprolactinomas (>10 mm) are the most common causes of hyperprolactinaemia. The prevalence of prolactinomas is unknown; in necropsy series, the rate varies between 23% and 27% for microadenomas.44, 45
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