ANDREA GLEZER
Projetos de Pesquisa
Unidades Organizacionais
Instituto Central, Hospital das Clínicas, Faculdade de Medicina - Médico
LIM/25 - Laboratório de Endocrinologia Celular e Molecular, Hospital das Clínicas, Faculdade de Medicina
LIM/25 - Laboratório de Endocrinologia Celular e Molecular, Hospital das Clínicas, Faculdade de Medicina
4 resultados
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bookPart Regulação Hipotálamo-hipofisária(2016) GLEZER, Andrea; BRONSTEIN, Marcelo Delano- Giant prolactinomas larger than 60 mm in size: a cohort of massive and aggressive prolactin-secreting pituitary adenomas(2016) SHIMON, Ilan; SOSA, Ernesto; MENDOZA, Victoria; GREENMAN, Yona; TIROSH, Amit; ESPINOSA, Etual; POPOVIC, Vera; GLEZER, Andrea; BRONSTEIN, Marcello D.; MERCADO, MoisesProlactin (PRL)-secreting macroadenomas usually measure between 10 and 40 mm. Giant (adenoma size a parts per thousand yen40 mm) PRL-tumors are not common, and larger prolactinomas (maximal diameter a parts per thousand yen60 mm) are rare, and their management outcomes have not been well characterized. We have identified 18 subjects (16 men, 2 females) with giant PRL-adenomas (size a parts per thousand yen60 mm; PRL > 1000 ng/ml) and summarized their characteristics and response to treatment. Mean age was 36.3 +/- 13.5 years (range 12-59 years). Mean adenoma size was 71.8 +/- 10.2 mm (60-92 mm). Complaints at presentation included headaches in 11 patients, visual deterioration in 9, sexual dysfunction in 9 males, and behavioral changes in two. Fourteen (78 %) had visual field defects. Mean PRL at presentation was 28,465 ng/ml (range 1300-270,000). All patients were treated with cabergoline (3.9 +/- 2.0 mg/week), except for one who received bromocriptine. Treatment achieved PRL normalization in 11/18 patients within a median interval of 20 months. Visual improvement occurred in 12/14 patients with pre-treatment visual abnormalities. Nine patients underwent surgery (transsphenoidal, 7; transcranial, 2). None of the seven patients with elevated PRL before surgery achieved remission post-operatively. After a follow-up of 7.8 +/- 5.1 years, 15/18 patients had significant adenoma shrinkage. Eleven patients are normoprolactinemic, 3 are partially controlled (PRL < 3 x ULN), and 4 remain with significantly elevated PRL. Most patients reported disappearance or improvement of their complaints. These enormous PRL-adenomas are invasive but respond fairly well to medical treatment. Long-term therapy with high dose cabergoline together with a pituitary surgery in some patients was the key for their successful management, achieving biochemical and clinical remission in most patients.
article 13 Citação(ões) na Scopus Pregnancy and pituitary adenomas(2016) GLEZER, Andrea; JALLAD, Raquel S.; MACHADO, Marcio C.; FRAGOSO, Maria Candida; BRONSTEIN, Marcello D.Infertility is frequent in patients harboring pituitary adenomas. The mechanisms involved include hypogonadism secondary to hormonal hypersecretion (prolactin, growth hormone and cortisol), stalk disconnection and pituitary damage. With the improvement of clinical and surgical treatment, pregnancy in women harboring pituitary adenomas turned into a reality. Pituitary hormonal hyper- and hyposecretion influences pregnancy outcomes, as well as pregnancy can interfere on pituitary tumors, especially in prolactinomas. We review literature about specific follow-up and management in pregnant women harboring prolactinomas, acromegaly, or Cushings disease and the impact of clinical and surgical treatment on each condition.bookPart Hiperprolactinemia e Prolactinomas(2016) MUSOLINO, Nina Rosa de Castro; PARAIBA, Diane Belchior; GLEZER, Andrea