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Báo cáo y học: " Prolactinoma presenting as chronic anaemia with osteoporosis: a case report"

Tuyển tập báo cáo các nghiên cứu khoa học quốc tế ngành y học dành cho các bạn tham khảo đề tài: Prolactinoma presenting as chronic anaemia with osteoporosis: a case report | MacLean and Hanley Journal of Medical Case Reports 2010 4 33 http www.jmedicalcasereports.eom content 4 1 33 jAc JOURNALOF medical ÌỤr case REPORTS CASE REPORT Open Access Prolactinoma presenting as chronic anaemia with osteoporosis a case report Fergus R MacLean1 John P Hanley2 Abstract Introduction Unexplained anaemia is a rare mode of presentation for prolactinoma. We describe a case of a man with chronic anaemia ascribed to old age. Six years later he was evaluated and diagnosed with a prolactinoma and resultant osteoporosis. Prolactinoma in old people may present insidiously with chronic anaemia and osteoporosis with or without sexual dysfunction. Case presentation We describe the case of a 70-year-old Caucasian man who presented with mild anaemia and tiredness. His anaemia was investigated and ascribed to senescence. Endocrine causes were not considered or tested for. Six years later he was again referred. Reassessment and direct questioning revealed long-standing sexual dysfunction. It was also discovered that our patient had fractured his radius twice with minor trauma during the preceding year. His serum prolactin was massively increased and a magnetic resonance imaging MRI scan of the head demonstrated a pituitary mass consistent with a prolactinoma. Dual X-ray absorptiometry revealed osteoporosis. Treatment of the prolactinoma led to a reduction in his serum prolactin with a rise in his haemoglobin to normal levels. This suggested that the prolactinoma was present during the initial presentation and was the cause of his anaemia. Conclusion This case highlights the importance of fully evaluating and investigating unexplained anaemia in older people and that endocrine causes should be considered. Osteoporosis also requires evaluation with secondary causes considered. Introduction Unexplained anaemia is a rare mode of presentation for prolactinoma. We describe a 70-year-old man whose diagnosis of prolactinoma was not revealed until after six years. During .