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Mohammad MM, Alidrisi HA, Mansour AA. Impulse Control Disorders in Southern Iraqi Patients Medicated With Cabergoline for Prolactinoma. Cureus 2024; 16:e58516. [PMID: 38957818 PMCID: PMC11218533 DOI: 10.7759/cureus.58516] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/18/2024] [Indexed: 07/04/2024] Open
Abstract
BACKGROUND Among the patient population in Basrah, Iraq, prolactinoma is the most commonly found pituitary tumor. Impulse control disorders (ICDs) were reportedly associated with these patients being treated with cabergoline. This study aimed to assess the prevalence of ICDs in cabergoline-treated prolactinoma patients versus healthy, matched controls. METHODS This cross-sectional case-control study was conducted at the Faiha Specialized Diabetes, Endocrine and Metabolism Center (FDEMC) in Basrah, southern Iraq, from January 2023 to May 2023. It included 30 cabergoline-treated prolactinoma patients and 30 healthy, matched controls. The questionnaire for ICDs in Parkinson's disease was used as a screening tool. Following this, positively screened patients were evaluated using validated criteria accordingly to diagnose impulse control disorders. RESULTS The ICDs were diagnosed in nine (30%) cabergoline-treated prolactinoma patients versus two (6.7%) in control (p = 0.02). The most frequent ICD types were hypersexuality and binge eating, while no patient reported pathological gambling. Three patients reported multiple types of ICDs. The patients' sociodemographic characteristics, prolactinoma duration and size, and cabergoline dose did not correlate significantly with ICD diagnosis. CONCLUSIONS Treatment with cabergoline is associated with the development of ICDs. Therefore, clinicians should be aware of this disabling side effect to ensure its early detection and treatment.
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Affiliation(s)
- Mohammad M Mohammad
- Medicine, Faiha Specialized Diabetes, Endocrine and Metabolism Center (FDEMC), Basrah, IRQ
- Medicine, College of Medicine, University of Basrah, Basrah, IRQ
| | - Haider A Alidrisi
- Diabetes and Endocrinology, Faiha Specialized Diabetes, Endocrine and Metabolism Center (FDEMC), Basrah, IRQ
- Diabetes and Endocrinology, College of Medicine, University of Basrah, Basrah, IRQ
| | - Abbas A Mansour
- Diabetes and Endocrinology, Faiha Specialized Diabetes, Endocrine and Metabolism Center (FDEMC), Basrah, IRQ
- Diabetes and Endocrinology, College of Medicine, University of Basrah, Basrah, IRQ
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Hussein IH, Mansour AA, Jameel NA. Comparing MRI volume measurement techniques for pituitary macroadenoma: Investigating volume reduction and its relationship with biochemical control. J Med Life 2023; 16:998-1006. [PMID: 37900080 PMCID: PMC10600678 DOI: 10.25122/jml-2022-0196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2022] [Accepted: 02/28/2023] [Indexed: 10/31/2023] Open
Abstract
Pituitary adenomas are one of the most common types of primary intracranial tumors. Measuring pituitary adenoma volume is fundamental for effective management. This study aimed to assess the reliability of the ellipsoid method in comparison with the perimeter method for measuring pituitary macroadenoma volume. In addition, we investigated the correlation between adenoma size reduction and biochemical control in functioning adenomas. This was a retrospective cross-sectional cohort study including 113 patients with pituitary macroadenomas. MRI was obtained for volume measurement by ellipsoid and perimeter methods using two types of DICOM viewer software. Both ellipsoid and perimeter methods exhibit positive, strong, and significant correlations in pituitary macroadenomas in pre-treatment and post-treatment volume (Spearman correlation coefficient 0.95, p-value <0.0001). There was no significant difference in the mean post-treatment pituitary adenoma volume measurements utilizing the ellipsoid and the perimeter methods in different treatment modalities. There were significant differences in the pre-treatment volume measurements between the two methods, both in NFPA and prolactinoma. No correlation was found between volume variability measured by ellipsoid and perimeter methods and the degree of hormonal control in functioning pituitary adenomas. Both the ellipsoid and perimetric methods can be utilized for pituitary adenoma volume measurements as they demonstrate a strong and positive correlation. However, it is important to note that the ellipsoid method tends to result in overestimated tumor volume. There was no correlation between the adenoma size reduction and the degree of biochemical response in functioning adenomas.
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Affiliation(s)
- Ibrahim Hani Hussein
- Department of Diabetes and Endocrinology, Faiha Specialized Diabetes, Endocrine, and Metabolism Center (FDEMC), Basrah, Iraq
| | - Abbas Ali Mansour
- Department of Diabetes and Endocrinology, Faiha Specialized Diabetes, Endocrine, and Metabolism Center (FDEMC), Basrah, Iraq
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Alzajaji QB, Alidrisi HA, Mansour AA. Correlation Between Clinical and Biochemical Markers in Patients With Acromegaly on Different Modalities of Treatment. Cureus 2021; 13:e19438. [PMID: 34909342 PMCID: PMC8663996 DOI: 10.7759/cureus.19438] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/10/2021] [Indexed: 12/05/2022] Open
Abstract
Background Acromegaly is a disabling disease caused by growth hormone (GH) over-secretion, associated with increased morbidity and mortality through different metabolic and somatic consequences involving soft tissue, acral overgrowth, and skin thickening, which will lead to different clinical manifestations. The study aimed to assess the correlation between biochemical markers of acromegaly with different clinical findings and biochemical control with the clinical findings. Methods A cross-sectional study was done on 56 patients with acromegaly attending a tertiary center for diabetes, endocrine, and metabolism in Southern Iraq Basrah. They were 32 (57.1%) males. Fatigue, headache, excessive sweating, joint pain, backache, soft tissue swelling, numbness, snoring, and visual problems were assessed on a four-point Likert scale. In addition, biochemical dynamic GH testing was done using a five-point random GH curve and/or standard GH suppression under the oral glucose tolerance test (OGTT). Results No significant correlation was found between symptoms severity and five-point GH parameters in respect of mean, peak, and nadir. Only backache showed a significant correlation with GH under OGTT suppression parameters in respect to mean, peak, and nadir (P-values < 0.01, < 0.01, and < 0.01), respectively. No particular biochemical control cut-off value in the 9 am random GH, mean five-point GH curve, or nadir GH under OGTT was correlated with the degree of severity for any of the clinical symptoms, as there was no difference between the biochemically controlled and uncontrolled groups in respect to any of the clinical symptom’s severity scale. Conclusion Only backache correlated with the biochemical tests of disease activity in the form of GH under OGTT. It appears in this study that the severity of the clinical symptoms does not correlate with biochemical control so that thorough evaluation and treatment of clinical complaints besides biochemical control is an essential part of the management plan in patients with acromegaly.
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Affiliation(s)
- Qusay Baqer Alzajaji
- Diabetes and Endocrinology, Faiha Specialized Diabetes, Endocrine and Metabolism Center (FDEMC), Basrah, IRQ.,Internal Medicine, University of Basrah, Basrah, IRQ
| | - Haider A Alidrisi
- Diabetes and Endocrinology, University of Basrah College of Medicine, Basrah, IRQ
| | - Abbas A Mansour
- Diabetes and Endocrinology, Faiha Specialized Diabetes, Endocrine and Metabolism Center (FDEMC) University of Basrah, Basrah, IRQ
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Al Dahmani K, Afandi B, Elhouni A, Dinwal D, Philip J, Bashier A, Beshyah SA, Nagelkerke N, Alkaabi JM. Clinical Presentation, Treatment, and Outcome of Acromegaly in the United Arab Emirates. Oman Med J 2020; 35:e172. [PMID: 32995046 PMCID: PMC7503193 DOI: 10.5001/omj.2020.114] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2019] [Accepted: 03/04/2020] [Indexed: 01/01/2023] Open
Abstract
Objectives We sought to ascertain the clinical characteristics and control rate of acromegaly in the UAE. Methods We conducted a multicenter retrospective analysis of all patients presenting with acromegaly to six endocrine centers in the UAE between November 2010 and December 2018. Demographic, clinical, biochemical, and radiologic data were collected. Patients were considered controlled if normal insulin-like growth factor-1 (IGF-1) level and growth hormone < 1 mcg/L were achieved at their last visit. Results A total of 75 patients were included in the study (60.0% males, 33.3% native UAE nationals). The mean age at diagnosis was 37.2 (range: 12-69) years. Common clinical features at diagnosis were headache (82.4%), coarse facial features (82.4%), acral enlargement (79.7%), and sweating (31.3%). Diabetes mellitus/prediabetes and hypertension were present in 45.2% and 35.5% of patients, respectively. About 82.2% had pituitary macroadenoma on pituitary magnetic resonance imaging. At presentation, 27.0% and 3.2% of the patients had secondary hypogonadism and diabetes insipidus, respectively. Overall, 76.7% of the patients underwent surgery, 20.8% received radiotherapy, and 50.7% received medical therapy. At their last clinic visit, only 43.7% of all patients achieved disease control. Conclusions Our study shows a high prevalence of pituitary macroadenoma in our acromegalic population, suggesting a delayed diagnosis. Also, a significant proportion of patients remained uncontrolled. Efforts to increase physician's awareness of acromegaly and to improve disease control are underway.
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Affiliation(s)
- Khaled Al Dahmani
- Endocrine and Diabetes Center, Tawam Hospital, Al Ain, UAE.,Department of Medicine, College of Medicine and Health Science, UAE University, Al Ain, UAE
| | - Bachar Afandi
- Endocrine and Diabetes Center, Tawam Hospital, Al Ain, UAE.,Department of Medicine, College of Medicine and Health Science, UAE University, Al Ain, UAE
| | - Ali Elhouni
- Endocrine and Diabetes Center, Tawam Hospital, Al Ain, UAE.,Department of Medicine, College of Medicine and Health Science, UAE University, Al Ain, UAE
| | - Denish Dinwal
- Division of Endocrinology, New Medical Center, Abu Dhabi, UAE
| | - Jim Philip
- Division of Endocrinology, New Medical Center, Al Ain, UAE
| | - Alaaeldin Bashier
- Department of Endocrinology, Dubai Hospital, Dubai Health Authority, Dubai, UAE
| | - Salem A Beshyah
- Division of Endocrinology, Mediclinic, Abu Dhabi, UAE.,Department of Medicine, Dubai Medical College, Dubai, UAE
| | | | - Juma M Alkaabi
- Department of Medicine, College of Medicine and Health Science, UAE University, Al Ain, UAE.,Division of Endocrinology, Al Ain Hospital, Al Ain, UAE
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Aldahmani KM, Sreedharan J, Ismail MM, Philip J, Nair SC, Alfelasi M, Aziz W, Imran SA, Alkaabi J. Prevalence and characteristics of sellar masses in the city of Al Ain, United Arab Emirates: 2010 to 2016. Ann Saudi Med 2020; 40:105-112. [PMID: 32241168 PMCID: PMC7118230 DOI: 10.5144/0256-4947.2020.105] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND The prevalence of sellar masses (SMs) is reported in Europe and North America but only limited data are available from the Middle East and North Africa (MENA) region. OBJECTIVES Assess the prevalence and characteristics of SMs in Al Ain city, United Arab Emirates. DESIGN Retrospective, descriptive multicenter study. SETTING Three endocrine centers in Al Ain. PATIENTS AND METHODS All patients diagnosed with SMs in the city of Al Ain, Emirate of Abu Dhabi, between 2011 and 2016 were evaluated. Cases were identified using ICD 9 and 10 codes and demographic and clinical data were collected. The prevalence rate was calculated for patients alive and residing in Al Ain city until 31 December 2016. MAIN OUTCOME MEASURES Clinical presentations and prevalence rate. SAMPLE SIZE 272. RESULTS The mean (SD) age on presentation was 40.8 (14.3) years (range: 6-114 years, median: 40.0). The 170 (61.8%) females and 128 (46.5%) were native citizens of the United Arab Emirates. Two hundred and forty five (90%) patients had pituitary adenomas (PAs) while 27 (10%) had non-pituitary sellar lesions. The four most common SMs were prolactinoma (n=139, 51.1%), nonfunctioning adenoma (NFA) (n= 69, 25.4%), somatotroph adenoma (n=32, 11.8%) and craniopharyngioma (n=15, 5.5%). Patients with prolactinoma, corticotroph adenoma, and Rathke's cleft cyst had small sellar masses (<1 centimeter) while the majority of patients with other SMs had macroadenomas. Hypogonadism and growth hormone deficiency was present in 41.8% and 20.5% of the patients, respectively. Of 268 patients with available data, 82 patients underwent surgery while 25 patients received radiotherapy. At the end of 2016, 197 patients were residing in Al Ain city. The overall prevalence of SMs was 25.7/100 000 with PAs constituting most of these masses (n=177) for a prevalence of 23.1/100 000. CONCLUSIONS This is the first study of SMs in the United Arab Emirates and the MENA region. Prolactinoma and NFA were the two most common SMs. Further studies are needed to explore the reasons for the lower prevalence of SMs in our region compared with other countries. LIMITATIONS Retrospective design, relatively small sample size. CONFLICT OF INTEREST None.
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Affiliation(s)
- Khaled M Aldahmani
- From the Division of Endocrinology, Tawam Hospital, Al Ain, Abu Dhabi, United Arab Emirates.,From the Department of Medicine, United Arab Emirates University, Al Ain, Abu Dhabi, United Arab Emirates
| | - Jayadevan Sreedharan
- From the College of Medicine, Gulf Medical University, Ajman, United Arab Emirates
| | - Mohamad Milad Ismail
- From the Division of Endocrinology, Al Ain Hospital, Al Ain, Abu Dhabi, United Arab Emirates
| | - Jim Philip
- From the Division of Endocrinology, New Medical Center, Al Ain, United Arab Emirates
| | | | - Mohammad Alfelasi
- From the Division of Ear, Nose and Throat Surgery, Tawam Hospital, Al Ain, Abu Dhabi, United Arab Emirates
| | - Waseem Aziz
- From the Department of Neurosurgery, Mediclinic, Al Ain, United Arab Emirates.,From the Department of Neurosurgery, Alexandria University, Egypt
| | - Syed Ali Imran
- From the Division of Endocrinology and Metabolism, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Juma Alkaabi
- From the Department of Medicine, United Arab Emirates University, Al Ain, Abu Dhabi, United Arab Emirates
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