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Biomedical subjects

M Alger

Publications and source records attributed to M Alger.

17 recordsLinked to original sources
PubMed1979

Clinical use of metoclopramide test in the diagnosis of women with hyperprolactinemia.

UNLABELLED: 14 women with elevated prolactin (PRL) serum levels (greater than 25 ng/ml) were given 2.5 mg of metoclopramide, by bolus intravenous injection, to evaluate its diagnosic potential as a stimulus for PRL release. Following metoclopramide injection there was a prompt increase in serum PRL in normal subjects and in patients with moderate PRL elevations associated with galactorrhea-oligomenorrhea. The women with amenorrhea-galactorrhea regardless of the presence of absence of a pituitary tumor, showed a blunted response. Metoclopramide failed to induce TSH secretion in all cases. IN CONCLUSION: the use of the metoclopramide test provides no additional clinical information to that furnished by the basal serum PRL concentration for the hyperprolactinemic patient.

Adult↗
PubMed1979

The effect of pregnancy and lactation on pituitary prolactin-secreting tumours.

Management of the amenorrhoea-galactorrhoea syndrome due to pituitary tumour is still controversial. However, in cases of pituitary prolactin-producing adenomas, ovulation and pregnancy are readily induced medically with bromocriptine. In our series of 14 patients conception occurred in all cases within 6 months of treatment. All of the 14 women had uneventful full term pregnancies and normal infants. Neither neurological nor visual symptoms appeared in these patients during their pregnancies. Lactation had no apparent effect on the growth of the pituitary tumour since radiological and neurological evaluations were unchanged. Prolactin levels for each patient following the termination of pregnancy and breast feeding were apparently diminished or similar to the prolactin levels obtained prior to treatment. This finding could add to the evidence that probably there was no further growth of the pituitary tumour. Three of the 14 women have had a second pregnancy without any complications. It is recommended that patients with microadenomas can be allowed to become pregnant on bromocriptine alone, provided that they are carefully supervised during pregnancy.

Adenoma↗
PubMed1979

Splenectomy for hemocytopenia in systemic lupus erythematosus. A controlled appraisal.

We compared 15 patients with systemic lupus erythematosus (SLE) treated with splenectomy for thrombocytopenic purpura and/or hemolytic anemia to 15 similar SLE patients treated only medically. There was no significant difference between the splenectomized and the nonsplenectomized patients when their entire course, as well as the presplenectomy and postsplenectomy or their equivalent control periods, were compared by means of an overall severity index. Splenectomized patients, however, had a significantly higher frequency of cutaneous vasculitis after splenectomy than in their own presplenectomy period and a significantly higher frequency of cutaneous vasculitis than the nonsplenectomized patients. Serious infections were more frequent in the postsplenectomy period than in an equivalent period in the nonsplenectomized patients. Splenectomy produced only short-term benefit in the management of hemocytopenic episodes in SLE and seems only warranted as an emergency procedure in patients unresponsive to medical treatment.

Anemia, Hemolytic↗
PubMed1977

Hemolytic anemia and thrombocytopenic purpura: two related subsets of systemic lupus erythematosus.

Systemic lupus erythematosus patients who develop hemolytic anemia or thrombocytopenic purpura differ from other lupus patients and are similar enough to be considered two related subsets with a more benign course. Thirty-one lupus patients with either or both these hemocytopenias were found to be significantly younger, more often males, and had less frequent fever, polyarthritis, serositis, cutaneous vasculitis, nephropathy, neurologic manifestations, and persistent hypocomplementemia than 62 lupus patients without any of these hemocytopenias. They also had lower index scores of overall disease severity and required less treatment. It seems important to subdivide lupus patients in subsets for therapeutic and prognostic purposes.

Adolescent↗
PubMedDate not supplied

Amenorrhea-galactorrhea associated with Cushing's disease due to pituitary tumor.

Two patients with amenorrhea-galactorrhea and Cushing's disease due to pituitary tumor are presented. In both cases, a diagnosis of prolactin-secreting tumor with moderate hyperprolactinemia was established, then Cushing's disease developed years later. Despite the typical clinical features of Cushing's disease, a dexamethasone suppression test inhibited both blood ACTH and cortisol concentrations in the 2 patients. Hypophysectomy was performed in 1 case, and the histologic study revealed the presence of a cromophobe adenoma. The other case was treated by external radiation which improved the clinical situation. Clinical and endocrinological studies in these 2 cases were compared with previous reports in the literature in order to discuss the etiology of this unusual association. It is concluded that patients with pituitary tumors presenting moderate hyperprolactinemia may also have excessive secretion of ACTH.

Adenoma, Chromophobe↗