Abstract
Prolactinomas are common pituitary tumors that can cause gonadal dysfunction and infertility related to hyperprolactinemia. Dopamine agonists are the first-line treatment in these patients. Cabergoline leads to significant reduction in serum prolactin levels and tumor size in patients with prolactinoma. Dopamine agonists have been associated with adverse effects such as nausea, vomiting and psychosis. We report here a case with cabergoline-induced immune hemolytic anemia. The patient had cabergoline treatment history for prolactinoma and presented with weakness, fatigue, nausea, and paleness. Laboratory findings revealed severe anemia-related immune hemolysis. There were no causes identified to explain hemolytic anemia except cabergoline. Therefore, cabergoline therapy was stopped and subsequently hemolytic anemia resolved and did not occur again. This is the first reported pediatric case with prolactinoma and cabergoline-induced hemolytic anemia. Clinicians should be watchful for this rare side effect induced by cabergoline.
References
1. Ben Jonathan N, Hnasko R. Dopamine as a prolactin (PRL) inhibitor. Endocr Rev 2001;22:724–63.10.1210/edrv.22.6.0451Search in Google Scholar
2. Ciccarelli A, Daly AF, Beckers A. The epidemiology of prolactinomas. Pituitary 2005;8:3–6.10.1007/s11102-005-5079-0Search in Google Scholar
3. Kars M, Dekkers OM, Pereira AM, Romijn JA. Neth J Med Update in prolactinomas 2010;68:104–12.Search in Google Scholar
4. Colao A, Sarno AD, Cappabianca P, Briganti F, Pivonello R, et al. Gender differences in the prevalence, clinical features and response to cabergoline in hyperprolactinemia. Eur J Endocrinol 2003;148:325–31.10.1530/eje.0.1480325Search in Google Scholar
5. Colao A, Vitale G, Cappabianca P, Briganti F, Ciccarelli A, et al. Outcome of cabergoline treatment in men with prolactinoma: effects of a 24-month treatment on prolactin levels, tumor mass, recovery of pituitary function, and semen analysis. J Clin Endocrinol Metab 2004;89:1704–11.10.1210/jc.2003-030979Search in Google Scholar
6. Di Sarno A, Landi ML, Cappabianca P, Di salle F, Francesca ER, et al. Resistance to cabergoline as compared with bromocriptine in hyperprolactinemia: prevalence, clinical definition, and therapeutic strategy. J Clin Endocrinol Metab 2001;86:5256–61.10.1210/jcem.86.11.8054Search in Google Scholar
7. Colao A, Di Sarno A, Cappabianca P, Di Somma C, Pivonello R, et al. Withdrawal of long-term cabergoline therapy for tumoral and nontumoral hyperprolactinemia. N Engl J Med 2003;349:2023–33.10.1056/NEJMoa022657Search in Google Scholar
8. Colao A, Di Sarno A, Landi ML, Scavuzzo F, Cappabianca P, et al. Macroprolactinoma shrinkage during cabergoline treatment is greater in naive patients than in patients pretreated with other dopamine agonists: a prospective study in 110 patients. J Clin Endocrinol Metab 2000;85:2247–52.10.1210/jc.85.6.2247Search in Google Scholar
9. Verhelst J, Abs R, Maiter D, Van den Bruel A, Vandeweghe M, et al. Cabergoline in the treatment of hyperprolactinemia: a study in 455 patients. J Clin Endocrinol Metab 1999;84:2518–22.10.1210/jcem.84.7.5810Search in Google Scholar
10. Mantegani S, Brambilla E, Varasi M. Ergoline derivatives: receptor affinity and selectivity. Farmaco 1999;54:288–96.10.1016/S0014-827X(99)00028-2Search in Google Scholar
11. Webster J, Piscitelli G, Polli A, Ferrari CI, Ismail I, et al. A comparison of cabergoline and bromocriptine in the treatment of hyperprolactinemic amenorrhea. Cabergoline Comparative Study Group. N Engl J Med 1994;331:904–9.10.1056/NEJM199410063311403Search in Google Scholar PubMed
12. Shrivastava RK, Arginteanu MS, King WA, Post KD. Giant prolactinomas: clinical management and long-term follow up. J Neurosurg 2002;97:299–306.10.3171/jns.2002.97.2.0299Search in Google Scholar
13. Eren E, Yapici S, Çakir ED, Ceylan LA, Saglam H, et al. Clinical course of hyperprolactinemia in children and adolescents: a review of 21 cases. J Clin Res Pediatr Endocrinol 2011;3:65–9.10.4274/jcrpe.v3i2.14Search in Google Scholar
14. Cho EH, Lee SA, Chung JY, Koh EH, Cho YH, et al. Efficacy and safety of cabergoline as first line treatment for invasive giant prolactinoma. J Korean Med Sci 2009;24:874–8.10.3346/jkms.2009.24.5.874Search in Google Scholar
15. Barker FG, Klibanski A, Swearingen B. Transsphenoidal surgery for pituitary tumors in the United States, 1996-2000: mortality, morbidity, and the effects of hospital and surgeon volume. J Clin Endocrinol Metab 2003;88:4709–19.10.1210/jc.2003-030461Search in Google Scholar
16. Biller BM, Molitch ME, Vance ML, Cannistraro KB, Davis KR, et al. Treatment of prolactin-secreting macroadenomas with the once-weekly dopamine agonist cabergoline. J Clin Endocrinol Metab 1996;81:2338–43.Search in Google Scholar
17. Gillam MP, Molitch ME, Lombardi G, Colao A. Advances in the treatment of prolactinomas. Endocr Rev 2006;27:485–534.10.1210/er.2005-9998Search in Google Scholar
18. Herzog A, Minne H, Ziegler R. Retroperitoneal fibrosis in a patient with macroprolactinoma treated with bromocriptine. Br Med J 1989;298:1315.10.1136/bmj.298.6683.1315-aSearch in Google Scholar
19. Pritchett AM, Morrison JF, Edwards WD, Schaff HV, Connolly HM, et al. Valvular heart disease in patients taking pergolide. Mayo Clin Proc 2002;77:1280–6.10.4065/77.12.1280Search in Google Scholar
20. Serratrice J, Disdier P, Habib G, Viallet F, Weiller PJ. Fibrotic valvular heart disease subsequent to bromocriptine treatment. Cardiol Rev 2002;10:334–6.10.1097/00045415-200211000-00005Search in Google Scholar
21. Van Camp G, Flamez A, Cosyns B, Goldstein J, Perdaens C, et al. Heart valvular disease in patients with Parkinson’s disease treated with high-dose pergolide. Neurology 2003;61:859–61.10.1212/01.WNL.0000083985.00343.F2Search in Google Scholar
22. Van Camp G, Flamez A, Cosyns B, Weytjens C, Muyldermans L, et al. Treatment of Parkinson’s disease with pergolide and relation to restrictive valvular heart disease. Lancet 2004;363:1179–83.10.1016/S0140-6736(04)15945-XSearch in Google Scholar
23. Baseman DG, O’Suilleabhain PE, Reimold SC, Laskar SR, Baseman JG, et al. Pergolide use in Parkinson disease is associated with cardiac valve regurgitation. Neurology 2004;63:301–4.10.1212/01.WNL.0000129842.49926.07Search in Google Scholar
24. Horvath J, Fross RD, Kleiner-Fisman G, Lerch R, Stalder H, et al. Severe multivalvular heart disease: a new complication of the ergot derivative dopamine agonists. Mov Disord 2004;19:656–62.10.1002/mds.20201Search in Google Scholar PubMed
25. Townsend M, MacIver DH. Constrictive pericarditis and pleuropulmonary fibrosis secondary to cabergoline treatment for Parkinson’s disease. Heart 2004;90:e47.10.1136/hrt.2004.036236Search in Google Scholar PubMed PubMed Central
26. Pinero A, Marcos-Alberca P, Fortes J. Cabergoline-related severe restrictive mitral regurgitation. N Engl J Med 2005; 353:1976–7.10.1056/NEJM200511033531822Search in Google Scholar PubMed
27. Yamamoto M, Uesugi T, Nakayama T. Dopamine agonists and cardiac valvulopathy in Parkinson disease: a case-control study. Neurology 2006;67:1225–9.10.1212/01.wnl.0000238508.68593.1dSearch in Google Scholar PubMed
28. Zanettini R, Antonini A, Gatto G, Gentile R, Tesei S, et al. Valvular heart disease and the use of dopamine agonists for Parkinson’s disease. N Engl J Med 2007;356:39–46.10.1056/NEJMoa054830Search in Google Scholar PubMed
29. Schade R, Andersohn F, Suissa S, Haverkamp W, Garbe E. Dopamine agonists and the risk of cardiac-valve regurgitation. N Engl J Med 2007;356:29–38.10.1056/NEJMoa062222Search in Google Scholar PubMed
30. Garratty G. Immune hemolytic anemia caused by drugs. Expert Opin Drug Saf. 2012;11:635–42.10.1517/14740338.2012.678832Search in Google Scholar PubMed
31. http://www.ehealthme.com/ds/dostinex/haemolytic+anaemia. Accessed 22 November, 2012Search in Google Scholar
32. Zemmoura I, Wierinckx A, Vasiljevic A, Jan M, Trouillas J, et al. Aggressive and malignant prolactin pituitary tumors: pathological diagnosis and patient management. Pituitary 2012 Nov 27. [Epub ahead of print].10.1007/s11102-012-0448-ySearch in Google Scholar PubMed
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