Evidence map›Paper›PMID 27600151›Full record

ArticlePituitary2016

Pituitary tumors in MEN1: do not be misled by borderline elevated prolactin levels.

Alina Livshits, Jelena Kravarusic, Ellie Chuang, Mark E Molitch

Abstract readCase Reports
PubMed Publisher
In one paragraph

Article in Pituitary, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
1.2field-weighted citation impact, top 19% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 8 citations in OpenAlex.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors at 4 institutions in 2 countries.

Alina LivshitsHadassah Medical School, Hebrew University of Jerusalem, Jerusalem, Israel.
Jelena KravarusicDivision of Endocrinology, Mercy Hospital, Chicago, IL, USA.
Ellie ChuangSouthern New Hampshire Diabetes and Endocrinology, Nashua, NH, USA.
Mark E MolitchDivision of Endocrinology Metabolism and Molecular Medicine, Northwestern University Feinberg School of Medicine, 645 N. Michigan Avenue, Suite 530, Chicago, IL, 60611, USA. molitch@northwestern.edu.ORCID http://orcid.org/0000-0002-8492-3587
Hebrew University of Jerusalem · ILMercy Hospital and Medical Center · USNorthwestern University · USSouthern New Hampshire Medical Center · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeThe objective of this case report is to demonstrate that the simple expedient of measuring periodic prolactin levels in patients with MEN1 who have modest hyperprolactinemia and normal pituitary MRI scans is insufficient to monitor for the development of pituitary adenomas.

methodsReview of relevant literature and chart review.

resultsA 25 year old man with known MEN1 manifested by hyperparathyroidism and a gastrin-producing neuroendocrine tumor was found to have a prolactin [PRL] level of 20.0 ng/mL [1.6-16 ng/mL] but a normal pituitary MRI scan. The impression then was that he had prolactinoma too small to be visualized on the MRI. Over the next 3.5 years his PRL levels remained in this mildly elevated range but he then presented with severe headaches and visual field defects. An MRI showed a 3.1 × 1.7 × 1.9 cm pituitary adenoma with compression of the optic chiasm and invasion of the left cavernous sinus. Surgery revealed a gonadotroph adenoma and he subsequently required gamma knife radiotherapy for residual tumor. Postoperative PRL levels were normal.

conclusionsSmall, intrasellar microadenomas may be associated with elevated PRL levels due to possible direct hormone production [prolactinoma] or possibly to interference with portal vessel blood flow. In monitoring hyperprolactinemic MEN1 patients for the development of pituitary adenomas, measurement of PRL levels is insufficient and periodic MRI scans are necessary at a more frequent interval than every 3-5 years. This may also pertain to patients with "idiopathic" hyperprolactinemia.

Indexed as

AdenomaAdultHumansMaleMultiple Endocrine Neoplasia Type 1Pituitary NeoplasmsProlactinProlactinMEN1Multiple endocrine neoplasiaPituitary adenomaProlactinProlactinoma

Identifiers

PMID27600151
OpenAlexW2516535012

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.