Syndrome of persistent lactation amenorrhea
Endocrinology / / August 12, 2017
In 1855 Chiari described the persistent lactation amenorrhea and uterine atrophy and ovarian cancer in women after childbirth.After 48 years, this syndrome has been thoroughly analyzed by Frommel.Further Argonz a.Del Castillo (1953), Forbes and others watched amenorrhea with reduced release of follicle stimulating hormone and persistent lactation in young women and girls not beremenevshih not given birth.Some patients with this syndrome have been found pituitary tumors or suprasellar region (for example, of the 15 patients observed Forbes and others), 8 were radiological signs of tumor.
Forbes and others expressed the view that persistent lactation is associated with increased production of prolactin tumor cells.However, it seems more likely assumption Folley, that persistent lactation is associated with damage to the hormonally inactive tumor or other pathological processes of hypothalamic centers that have an inhibitory effect on the production of prolactin.This assumption is based on experimental st
Along with laktoreey and amenorrhea, some patients have other endocrine and metabolic disorders -.. Obesity or emaciation, hypertrichosis, thirst, etc.
Thus, the data currently available allow us to consider the syndrome of persistent lactation amenorrhea as a damage syndromehypothalamus with secondary endocrine disorders.Apparently, the most common cause of damage is the compression of the hypothalamus or the germination of hormonally inactive tumor, but we can not exclude the possibility of other pathological processes in this area.
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in the diagnosis of the pathological process leading to the development of the syndrome of persistent lactation amenorrhea, be aware that the appearance of these symptoms may be many years preceded by other symptoms, allowing to establish the presence of a tumor.So, in observing Suchenwirth Bues and in patients who have suffered postpartum laktoreey and amenorrhea, only 16 years after the onset of the disease appeared bitemporal hemianopsia, which allowed to diagnose a pituitary tumor.Removing chromophobe adenoma in this patient after 26 years from the onset of the disease has led to the cessation of lactation.In 5 of 6 patients ,null, observed Canfleld and Bates, whose cause of the syndrome of persistent lactation amenorrhea was chromophobe pituitary adenoma ,null, duration of the disease from appearing before the development of symptoms of lactation, established the presence of the tumor ranged from 2 to 10 years.
Therefore, all patients with a syndrome of persistent lactation amenorrhea should be subject to periodic X-ray, ophthalmic and neurological examination aimed at identifying tumor dientsefalo-pituitary region.
describes individual cases of persistent lactation in patients with Sheehan's syndrome.
Symptomatic treatment of sex hormones, as with other forms of amenorrhea, in some patients reduces lactation, others such and such action is not.
cessation of lactation was observed after removal of the tumor and Suchenwirth Bues or treatment of tumors with radioactive.