Clinical characteristics, diagnosis and treatment response of adult prolactinoma patients on follow up at endocrine clinic of TikurAnbessa Specialized Hospital during the period from June 2015 to June2020, Addis Ababa, Ethiopia.
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Date
2020-06
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Addis Abeba University
Abstract
BACKGROUND-Prolactinomas are the most common type of pituitary adenomas in both sexes
with different age distribution.They are benign neoplasms accounting for approximately 40% of
all pituitary tumors. They are classified into two main groups based on the size of pituitary
tumour at presentation: microprolactinoma (tumour diameter <1 cm) and macroprolactinoma
(tumour diameter >1 cm). The clinical presentation of prolactinoma includes manifestations
relating to hyperprolactinaemia and features relating to tumor bulk.
OBJECTIVE- The objective of this study is to assess the clinical profile, diagnosis and treatment
response of patients with prolactinoma on follow up at endocrine clinic ofTikurAnbessa
specialized Hospital(TASH).
METHOD; Ahospital based retrospective cross sectional study was conducted on adult patients
with confirmed prolactinoma attending Endocrine clinicof TASH from June, 2015 to June 2020.
All patients with prolactinoma on follow up at endocrine clinic of TASHon the stated period
were included. Data collection was conducted by the principal investigatorfrom the charts and
electronic medical records of patients using a structured questionnaire. Data was cleared and
entered to IBM SPSS version 26. Result was processed and analyzed using SPSS version
26.Descriptive statistics were used as a statistical data analysis method and presented as
frequencies and percentages with their corresponding confidence intervals. Logistic regression
analysis was used to assess the association between initial tumor size and prolactin level and a P
value of <0.05 was considered significant.
Result:Among the 217 patients with pituitary adenoma, prevalence of prolactinomawas
91(41.9%). 76.8% patients with prolactinoma were females. The mean age was 30.78 years
(SD±7.97). Headache was the major presenting symptom (68.1%) followed by visual
disturbance (49.3%).Most patients (79.7%) had macroadenoma. PRL level was <250ng/ml in
54.71% females and >500ng/ml in 56.25% males. 67out of the 69 patients were treated
(medical and/or surgical). 59(85.5%)patients had clinical response and 10 (14.5%) had no
clinical response.On multivariate logistic regression the prolactin level has strong association
with the initial tumor size with p value <0.003, AOR of 19.51, 95% CI (2.689, 141.6). Treatment
was discontinued in 16 out of the 65 patients and disease remission and financial limitation
were the major reasons.
Conclusion: Prolactinomas are the most common secretory pituitary tumors accounting for
41.9%. The initial tumor size has association with the presenting symptom and initial prolactin
level. Our Patients with prolactinoma has good clinical response to medical therapy
Recommendation- Laboratory investigations of hormonal analysis, MRI and drugs (dopamine
agonists) should be available in the hospital.
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Keywords
Prolactinoma, TASH,prolactinoma, medical therapy, dopamine agonists