Artikel
Increased risk for venous thrombembolism in patients with surgically treated prolactinomas? : in-vitro, in-vivo and clinical data on the thrombogenic effect of hyperprolactinemia
Erhöhtes Risiko venöser thrombembolischer Ereignisse bei Patienten mit operativ therapierten Prolaktinomen? : In-vitro, in-vivo und klinische Daten zum thrombogenen Effekt der Hyperprolaktinämie
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Autoren
Veröffentlicht: | 4. Mai 2005 |
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Gliederung
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Objective
In a previous study we demonstrated that hyperprolactinemia causes increased ADP -dependent stimulation of platelets both in vitro and in vivo. Moreover, we found a higher incidence of venous thrombembolism (VTE) in patients with medically treated prolactinomas compared to the incidence among the general population. We wanted to further clinically verify our data by investigating the incidence of venous thrombembolism among patients, who underwent transsphenoidal surgery for different subtypes of pituitary adenomas.
Methods
In an attempt to analyze the association between hyperprolactinemia and VTE in patients with pituitary tumors, especially PRL-secreting pituitary adenomas, we retrospectively investigated 660 patients, who had undergone transsphenoidal surgery by sending out a questionnaire. 311 patients replied reliably and were included in the statistical analysis. Based on the preoperative hormonal findings and the immunohistochemistry results, we analyzed 75 patients with PRL-secreting adenomas in comparison to a control group of patients without serum hyperprolactinemia (27 GH-secreting adenomas and 209 non-functioning pituitary adenomas).
Results
In patients with non-functioning adenomas, we detected 6 (2.9%) pre- and 1 (0.5%) postoperative VTE, whereas patients with GH-adenomas were found to have 1 preoperative VTE (3.7%). Supporting our data on medical treated PRL-secreting pituitary adenomas, patients with prolactinomas on the one hand again showed a significantly (p<0.001) higher incidence of pre- n=5 (6.7%) but on the other hand also a significantly higher rate of postoperative VTE n=5 (6.7%) compared to patients with non-functioning-adenomas, GH-secreting adenomas or the general population.
Conclusions
Our study further supports the fact that patients with prolactinomas either treated surgically or medically seem to have an increased risk for VTE. One of the reasons of this increased risk might be the thrombogenic effect of hyperprolactinemia mediated by enhanced platelet reactivity.