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Dopamine agonists represent the treatment of choice for hyperprolactinemic amenorrheas during adolescence. In order to evaluate a new long-acting drug CAB (l-[6 allylergolin-8-ß-il-carbonyl]-1-[3(diethylamino)propy1]3-ethylurea) we studied 5 hyperprolactinemic adolescents with a chronological age between 16 and 18 years (1 microadenoma, 2 residual hyperorolactinemias following pituitary aoenoma surgery and 2 idiopathic hyoerprolactinemias). Four of them received bromocriptine (BEC) during 24 weeks. Prolactin (PRL) was measured basally and after 4, 8, 12, 16, 20 and 24 weeks oi treatment. After a 4 week wash-out period, CAB was administered and PRL was measured basally and at monthly intervals for 48 weeks. The fifth catient only received CAB treatment for 48 weeks. BEC was administered at variable doses of 2.5 mg three or four times per day, and CAB was administered at a single weekly dose of 0.5 to 1mg. Serum PRL was measured by RIA and statistical evaluation was performed with Wiicoxon's test. Results are presented m the table (mean ± SEM).All patients resumed menstrual and ovulatory cycles. No tumor relapse was observed in the patients with residual hyperprolactinemias following pituitary surgery, whereas in the patient with microadenoma no tumor was visualized on CT at 48 weeks. Conclusions: 1) At 24 weeks there were no significant differences in the PRL values observed in patients treated with BEC or CAB. 2) The effect achieved with CAB persisted at 48 weeks. 3) CAB was effective in restoring gonadal function, mantaining asymptomatic patients who had undergone pituitary surgery and causing the tumor image to disappear. 4) Due to its long - acting properties, its ease of administration, and its low incidence of side-effects, CAB appears to be a useful treatment for hyperprolactinemia in adolescents.

Approximately 10-20% of the prolactinomas are recognized before age 20. However, there are few reports on their medium and long term follow-up. Thirteen patients (8?, 9?) aged 14,2 - 20 yr. ([Xmacr ] 16,5 yr) with prolactinoma were followed for 9 m-12 yr. Headaches, impairment of pubertal development, galactorrhea and visual field defects were the most common clinical findings. The responses of LH and FSH to LHRH among patients varied from normal, exaggerated or absent. THe TRH (TSH) test was normal in 8/9 cases and in 1 ? a primary concomitant hypothyroidism was reported. Serum PRL was elevated in all patients ranging 77-1150 ng/ml ([Xmacr ] 378±285). PRL response after TRH was inadequate ([Xmacr ] ? MAX:25%). Radiologically, the patients were classified (Vezina and Sutton) in Gl: n=3 (?); G2: n=5 (4?, 1?); G3: n=3 (1?, 2?) and G4: n=2 (?). Eight patients (4?, 4?) were initially treated with surgery, 7 of them (3?, 4?) with a persistent hyperprolactinemia required Bromocriptine (BEC) after surgery. In 5 cases (4?, 1?) SEC constituted the primary treatment, but 1 ? with failure to BEC therapy needed transsphenoidal adenomectomy. Follow-up was possible in 11 patients. Among those who underwent surgery, 1 ? recovered gonadal function spontaneously and 5 cases (3 ?, 2?) required complementary medical treatment. Among those treated initially with BEC 1? recovered menses spontaneously, 1 ? needed progesterone therapy, 1 ? did not achieve normal PRL values after 9 m of treatment, the adolescent who required surgery had normal PRL levels without menses and the ? recovered gonadal function. In conclusion: - Basal PRL levels seem to be the most relevant element in hte diagnosis of prolactinomas.