Nephrotic-range proteinuria in a patient with a giant prolactinoma

We report for the first time a case of nephrotic-range proteinuria adequately controlled by using dopamine agonists. A 40-year-old man was studied because of persistent asymptomatic nephrotic proteinuria despite lifestyle modifications and treatment with converting enzyme inhibitors. The renal biops...

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Bibliographic Details
Published inAmerican journal of kidney diseases Vol. 51; no. 6; p. 1025
Main Authors Heras, Manuel, Iglesias, Pedro, Fernández-Reyes, María J, Sánchez, Rosa, Jiménez, María J, Muñoz, Henar, Tajada, Pilar, Duarte, Jacinto
Format Journal Article
LanguageEnglish
Published United States 01.06.2008
Subjects
Adult
Dopamine Agonists - therapeutic use
Ergolines - therapeutic use
Humans
Hyperprolactinemia - drug therapy
Hyperprolactinemia - etiology
Male
Pituitary Neoplasms - complications
Pituitary Neoplasms - pathology
Prolactinoma - complications
Prolactinoma - pathology
Proteinuria - etiology
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Summary:We report for the first time a case of nephrotic-range proteinuria adequately controlled by using dopamine agonists. A 40-year-old man was studied because of persistent asymptomatic nephrotic proteinuria despite lifestyle modifications and treatment with converting enzyme inhibitors. The renal biopsy specimen did not show histopathologic changes. In the follow-up period, a giant prolactinoma was found by chance with extremely high prolactin (PRL) values. After establishing cabergoline therapy, we achieved a remarkable decrease in both serum PRL levels and tumor mass, and surprisingly, proteinuria disappeared. We discuss the possible pathogenic mechanisms of proteinuria that may correspond to PRL level in urine (prolactinuria) or another tumor-related protein.
ISSN:1523-6838
DOI:10.1053/j.ajkd.2008.02.310