Schweizerische Rundschau für Medizin Praxis = Revue suisse de médecine Praxis
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Mortality and physical impairment in patients undergoing cardiac surgery are to a large extent due to cerebro-vascular complications that are second in frequency only to cardiopulmonary incidents. In spite of the extracorporeal circulatory support as well as progress in cardiac surgery that have improved the perioperative conditions, neurologic complications mainly of embolic nature are still common after extracorporeal circulatory assistance.
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Schweiz. Rundsch. Med. Prax. · Dec 1992
Case Reports[Drug-induced hyperprolactinemia and galactorrhea].
A 21 year old female treated for recurring gastric troubles with dopamine-antagonists (domperidone, metoclopramide) developed a clinically manifest hyperprolactinemia (3055 microU/l; normal value < 650 microU/l) with galactorrhea only two days after a new two day course of metoclopramide. The drug was withdrawn and within days mastodynia and galactorrhea subsided. A control of plasmatic prolactin two weeks later yielded a normal value (358 microU/l). ⋯ It is unclear why this patient inspite of repeated administration of one dopamine antagonist remained asymptomatic whereas the other after a short time and only a few doses led to galactorrhea. It is conceivable that differences in passage into the cerebrospinal fluid or the better penetration of the blood-brain barrier favored the development of galactorrhea under metoclopramide. This case served to discuss the pathophysiologic background of drug-induced hyperprolactinemia.