Katapleksija kod bolesnice sa prolaktinomom

  • Marina Nikolić-Djurović Clinical Centre of Serbia, Clinic of Endocrinology, Diabetes and Metabolic Diseases, Belgrade, Serbia; University of Belgrade, Faculty of Medicine, Belgrade, Serbia
  • Albero M. Pereira Leiden University Medical Center, Department of Medicine, Division of Endocrinology, Leiden, The Netherlands
  • Zvezdana Jeumović Clinical Centre of Serbia, Clinic of Endocrinology, Diabetes and Metabolic Diseases, Belgrade, Serbia
  • Dragan Pavlović University of Belgrade, Faculty of Medicine, Belgrade, Serbia
  • Dragana Janković Clinical Centre of Serbia, Clinic of Endocrinology, Diabetes and Metabolic Diseases, Belgrade, Serbia
  • Milan Petakov Clinical Centre of Serbia, Clinic of Endocrinology, Diabetes and Metabolic Diseases, Belgrade, Serbia; University of Belgrade, Faculty of Medicine, Belgrade, Serbia
  • Milorad Čivčić Clinical Centre of Serbia, Clinic of Endocrinology, Diabetes and Metabolic Diseases, Belgrade, Serbia
  • Olga Vasović Institute for Gerontology and Palliative Care, Belgrade, Belgrade, Serbia
  • Svetozar Damjanović Clinical Centre of Serbia, Clinic of Endocrinology, Diabetes and Metabolic Diseases, Belgrade, Serbia; University of Belgrade, Faculty of Medicine, Belgrade, Serbia
DOI: https://doi.org/10.2298/VSP160118102N
Ključne reči: prolactinoma||, ||prolaktinom, pituitary neoplasms||, ||hipofiza, neoplazme, cataplexy||, ||katapleksija, comor-bidity||, ||komorbiditet, diagnosis||, ||dijagnoza, magnetic resonance imaging||, ||magnetna rezonanca, snimanje, genet-ics, medical||, ||genetika, medicinska, treatment outcome||, ||lečenje, ishod,

Sažetak


Uvod. Izolovana katapleksija bez prisustva narkolepsije relativno je retko stanje i može se smatrati napadom motorne inhibicije sa gubitkom mišićnog tonusa i arefleksijom. Dijagnoza katapleksije se oslanja na kliničku prezentaciju i medicinsku dokumentaciju  i retko se potvrđuje video-poligrafom. Opisali smo bolesnicu tretiranu zbog prolaktinoma koja je razvila izolovanu katapleksiju. Prikaz bolesnika. Kod bolesnice stare 53 godine lečene bromokriptinom zbog  makroprolaktinoma ispoljile su se iznenadne, nagle epizode slabosti i nedostatak mišićne snage u nogama, koji su doveli do padova i povreda u nekoliko navrata. Kardiovaskularna evaluacija bila je potpuno normalna. Psihijatrijska procena je pokazala da bolesnica nije imala psihotičnu fenomenologiju  ni samoubilačke ideje. Snimci hipofize pokazali su prazno tursko sedlo (empty sella) sa ostatkom selarne mase sa infra i paraselarnim širenjem. Neurološki pregled pokazao je blagu opstruktivnu hipopneju/apneju u snu. Elektroencefalogramski nadzor u toku sna i buđenja nije pokazao epi potencijale. HLA halotipizacija bila je pozitivna za HLA-DR3,16, DR51, DK1 alele, potvrđujući dijagnozu izolovane katapleksije. Terapija sa uključenjem tricikličnih antidepresiva i smanjenjem doze bramokriptina dovela je do rezolucije katapleksije. Zaključak. Prikazan je prvi slučaj izolovane katapleksije koji je najverovatnije povezan sa terapijom prolaktinoma dopaminskim agonistom.

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Objavljeno
2017/09/19
Broj časopisa
Vol. 74 Br. 8 (2017)
Rubrika
Prikaz bolesnika