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Suppurative meningitis: A life-threatening complication in male macroprolactinomas

BACKGROUND: Suppurative meningitis (SM) or bacterial meningitis is a life-threatening condition, which is exceptionally due to pituitary tumors (PT). Our aim was to analyze its frequency among male macroprolactinomas (MPRL) deemed to be aggressive, to report the cases we observed in our practice and...

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Autores principales: Chentli, Farida, Akkache, Lina, Daffeur, Katia, Haddad, Meriem, Azzoug, Said
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Medknow Publications & Media Pvt Ltd 2013
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3830274/
https://www.ncbi.nlm.nih.gov/pubmed/24251128
http://dx.doi.org/10.4103/2230-8210.119524
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author Chentli, Farida
Akkache, Lina
Daffeur, Katia
Haddad, Meriem
Azzoug, Said
author_facet Chentli, Farida
Akkache, Lina
Daffeur, Katia
Haddad, Meriem
Azzoug, Said
author_sort Chentli, Farida
collection PubMed
description BACKGROUND: Suppurative meningitis (SM) or bacterial meningitis is a life-threatening condition, which is exceptionally due to pituitary tumors (PT). Our aim was to analyze its frequency among male macroprolactinomas (MPRL) deemed to be aggressive, to report the cases we observed in our practice and describe the circumstances under which SM appeared. MATERIALS AND METHODS: We retrospectively analyzed 82 male MPRL in order to look for a history of well proved SM and the circumstances under which SM appeared. We also took into account the possibility of SM relapsing. RESULTS: Four out of 82 male MPRL had SM = 4.87%. Three consulted for SM symptoms. SM was confirmed in Infectious Diseases department, but only one had rhinorrhea. Hormonal assessment and cerebral magnetic resonance imaging pleaded for aggressive prolactinomas. After antibiotics, SM was sterilized. Then, MPRL were treated with bromocriptine, which normalized prolactin and reduced PT. SM never relapsed. The 4(th) case was hospitalized for a large multidirectional prolactinoma invading and/or arising from the skull base. He was operated on 3 times and then he was given Bromocriptine. After 3 months, he had rhinorrhea and then SM which was successfully treated by antibiotics. SM never relapsed after tumor reduction. CONCLUSION: SM was demonstrated in 4.87%. SM has revealed MPRL in 3 cases and appeared after bromocriptine intake in the 4(th) one. Endocrinologists should be aware of this severe condition, which can be avoided by repairing as soon as possible the bony defect secondary to aggressive tumors, unless it is clogged by fibrosis: What probably happened in our cases.
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spelling pubmed-38302742013-11-18 Suppurative meningitis: A life-threatening complication in male macroprolactinomas Chentli, Farida Akkache, Lina Daffeur, Katia Haddad, Meriem Azzoug, Said Indian J Endocrinol Metab Brief Communication BACKGROUND: Suppurative meningitis (SM) or bacterial meningitis is a life-threatening condition, which is exceptionally due to pituitary tumors (PT). Our aim was to analyze its frequency among male macroprolactinomas (MPRL) deemed to be aggressive, to report the cases we observed in our practice and describe the circumstances under which SM appeared. MATERIALS AND METHODS: We retrospectively analyzed 82 male MPRL in order to look for a history of well proved SM and the circumstances under which SM appeared. We also took into account the possibility of SM relapsing. RESULTS: Four out of 82 male MPRL had SM = 4.87%. Three consulted for SM symptoms. SM was confirmed in Infectious Diseases department, but only one had rhinorrhea. Hormonal assessment and cerebral magnetic resonance imaging pleaded for aggressive prolactinomas. After antibiotics, SM was sterilized. Then, MPRL were treated with bromocriptine, which normalized prolactin and reduced PT. SM never relapsed. The 4(th) case was hospitalized for a large multidirectional prolactinoma invading and/or arising from the skull base. He was operated on 3 times and then he was given Bromocriptine. After 3 months, he had rhinorrhea and then SM which was successfully treated by antibiotics. SM never relapsed after tumor reduction. CONCLUSION: SM was demonstrated in 4.87%. SM has revealed MPRL in 3 cases and appeared after bromocriptine intake in the 4(th) one. Endocrinologists should be aware of this severe condition, which can be avoided by repairing as soon as possible the bony defect secondary to aggressive tumors, unless it is clogged by fibrosis: What probably happened in our cases. Medknow Publications & Media Pvt Ltd 2013-10 /pmc/articles/PMC3830274/ /pubmed/24251128 http://dx.doi.org/10.4103/2230-8210.119524 Text en Copyright: © Indian Journal of Endocrinology and Metabolism http://creativecommons.org/licenses/by-nc-sa/3.0 This is an open-access article distributed under the terms of the Creative Commons Attribution-Noncommercial-Share Alike 3.0 Unported, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Brief Communication
Chentli, Farida
Akkache, Lina
Daffeur, Katia
Haddad, Meriem
Azzoug, Said
Suppurative meningitis: A life-threatening complication in male macroprolactinomas
title Suppurative meningitis: A life-threatening complication in male macroprolactinomas
title_full Suppurative meningitis: A life-threatening complication in male macroprolactinomas
title_fullStr Suppurative meningitis: A life-threatening complication in male macroprolactinomas
title_full_unstemmed Suppurative meningitis: A life-threatening complication in male macroprolactinomas
title_short Suppurative meningitis: A life-threatening complication in male macroprolactinomas
title_sort suppurative meningitis: a life-threatening complication in male macroprolactinomas
topic Brief Communication
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3830274/
https://www.ncbi.nlm.nih.gov/pubmed/24251128
http://dx.doi.org/10.4103/2230-8210.119524
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