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Open Access 01-02-2025 | Prolactinoma

Exploring sex-specific hematological changes and their impact on quality of life in patients with prolactinoma

Authors: Mario Detomas, Timo Deutschbein, Pasquale Dolce, Yvonne Möhres, Martin Fassnacht, Barbara Altieri

Published in: Pituitary | Issue 1/2025

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Abstract

Context

Despite prolactin´s (PRL) role in stimulating hematopoiesis, anemia is commonly observed in men with macroprolactinomas. However, hematological changes in men with microprolactinomas and women with prolactinomas remain unexplored, and the impact of erythropoietic alterations on quality of life (QoL) is still unclear.

Objective

To explore sex-related changes in red blood cell (RBC) parameters and their potential impact on QoL at initial diagnosis of prolactinoma and after normalization of PRL under dopamine agonists.

Design

Retrospective, monocentric study involving 205 patients with prolactinoma (127 women, 62%). The SF-36 QoL questionnaire was administered to 57 women and 34 men.

Results

In women, no significant changes in RBC parameters were observed at diagnosis or after PRL normalization, regardless the adenoma size. Conversely, men with microprolactinoma showed a significant increase in hematocrit (HCT) and hemoglobin (Hb) levels after PRL normalization (median HCT 42.3 vs.44.0%; Hb 14.5 vs. 15.1 g/dL; both p < 0.005). Men with macroprolactinoma exhibited similar improvements (HCT 40.2 vs. 43.9%; Hb 14.0 vs. 15.1 g/dL; both p < 0.0001). In men, hypogonadism was observed in 73% of patients at baseline, and in 11% after PRL normalization. In male patients where SF-36 was administered at diagnosis and after PRL normalization, energy improvement was observed (median 50 vs. 60, p < 0.05). While changes in Hb and HCT were not significantly impacting the QoL of women and men, persistence of hypogonadism after PRL normalization, negatively impacted all the QoL scores of men.

Conclusion

Patients with prolactinoma show sex-dependent changes in RBC parameters. Unlike women, men exhibit decreased HCT and Hb levels irrespective of adenoma size. Of note, the failure to recover from hypogonadism significantly affected the QoL of men.
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Metadata
Title
Exploring sex-specific hematological changes and their impact on quality of life in patients with prolactinoma
Authors
Mario Detomas
Timo Deutschbein
Pasquale Dolce
Yvonne Möhres
Martin Fassnacht
Barbara Altieri
Publication date
01-02-2025
Publisher
Springer US
Published in
Pituitary / Issue 1/2025
Print ISSN: 1386-341X
Electronic ISSN: 1573-7403
DOI
https://doi.org/10.1007/s11102-024-01493-x

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