Abstract
We present a case of a 21 year old male patient diagnosed with a 2.2 cm prolactin-secreting adenoma in contact with the optic chiasm. The patient was treated with up to 6mg/week of cabergoline (total cumulative dose 814 mg) and developed mild valvulopathy. Valvulopathy was subsequently reversed after discontinuation of cabergoline therapy.
Highlights
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Cabergoline has been implicated in the induction of fibrotic cardiac valvulopathy when used in high doses mostly for the treatment of Parkinson’s disease[2,3] and in treatment of prolactinomas[4,5,6]
Other studies have not shown a significant increase in cardiac valvular disease when cabergoline was used in patients with pituitary diseases[7,8,9,10]
Summary
As prolactin level remained elevated after a further 3 months of treatment, cabergoline dose was increased to 5 mg in a divided dose twice a week. He continued to tolerate DA therapy without side effects. The patient’s prolactin level increased to 70 ng/ml (normal range: 3–13 ng/ml) 2 months after switching from cabergoline therapy to bromocriptine. On review of the echocardiogram no appreciable evidence was found for ongoing disease and follow up echocardiography was recommended after a further 6 months At this exam, a normal LV systolic function was found with an LV ejection fraction estimated at 62% using biplane Simpson’s method. No other echocardiographic abnormalities were found and improvement from previous echocardiograms was reported
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