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Follicle stimulating hormone - secreting pituitary adenoma: inappropriate secretion and effect of pulsatile luteinizing hormone releasing hormone analogue (buserelin) administration

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Abstract

A patient with an FSH secreting pituitary adenoma is reported. Elevated FSH and serum free α-subunit (SU) with low levels of LH and testosterone (T) were found. Immunostaining showed the presence of α-SU, FSH-β and LH-β subunits. LHRH analogue (buserelin) was administered in a pulsatile manner, by portable computerized infusion pump sc for ten days. During the first 24 h of treatment FSH, LH (p < 0.001) and T (p < 0.01) rose significantly. Ten days later, the expected desensitization phenomenon did not occur, but further increases of T (8.4 ± 2.6, mean ± SD, vs 17.4 ± 4.1 nmol/l, p < 0.001) and FSH (58.9 ± 9.6 vs 70.7 ± 3.8 mlU/ml, p < 0.001) were registered. LH decreased (12.5 ± 2.4 vs 7.1 ± 0.6 mlU/ml, p < 0.001) at day 10, but remained higher than basal level (5.0 ± 0.6, p < 0.001). Free α-SU also rose (2.8 ± 0.4 vs 4.4 ± 1.7 mlU/ml, p < 0.001) after ten days of treatment. The chronic stimulatory effect of analogue on LH with a lack of desensitization suggests tumorous secretion despite a partially preserved negative feedback of testosterone. Low basal LH levels, in some patients with FSH secreting tumors may not be due to tumor mass effect, but rather may be the consequence of altered LH production and/or secretion by the tumor. Although bureselin may not have a therapeutic effect, it is of use in differential diagnosis of hypergonadotrophinemia.

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Authors and Affiliations

  1. University Clinical Center, Institute of Endocrinology, Diabetes and Metabolic Diseases, Dr. Subotića 13, 11000, Beograd, Yugoslavia

    Svetozar Damjanović, D. Micić, V. Popović, M. Petakov, A. Kendereški, M. Šumarac, D. Manojlović & J. Mićić

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  1. Svetozar Damjanović
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  2. D. Micić
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  3. V. Popović
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  4. M. Petakov
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Damjanović, S., Micić, D., Popović, V. et al. Follicle stimulating hormone - secreting pituitary adenoma: inappropriate secretion and effect of pulsatile luteinizing hormone releasing hormone analogue (buserelin) administration. J Endocrinol Invest 14, 299–304 (1991). https://doi.org/10.1007/BF03346818

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  • DOI: https://doi.org/10.1007/BF03346818

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