Diagnosis and treatment of hyperprolactinemia

Shlomo Melmed, Felipe F. Casanueva, Andrew R. Hoffman, David L. Kleinberg, Victor M. Montori, Janet A. Schlechte and John A. H. Wass. Diagnosis and Treatment of Hyperprolactinemia: An Endocrine Society Clinical Practice Guideline. J Clin Endocrinol Metab, Vol. 96 (2): 273-288

Using the GRADE (Grading of Recommendations, Assessment, Development and Evaluation) system to describe both the strength of recommendations and the quality of evidence, the task force provide 20 recommendations or suggestions over six categories, including diagnosis and causes of hyperprolactinemia; management of drug-induced hyperprolactinemia and of prolactinomas; resistant and/or malignant tumors; and management of prolactinoma during pregnancyNature Reviews Endocrinology 7, 247

Do we need to routinely monitor BMD in patients on bisphosphonate therapy?

Is it helpful to routinely monitor bone mineral density in patients who are being activley treated with bisphosphonates? If so, do we need to check both hip and spine BMD or would either of the two be suficient on its own? The National Osteoporosis guideline has no recommendations on this yet but this study provides useful evidence to guide future practice.


Acromegaly Management


Here are the latest guidelines for the management of acromegaly following the Consensus Group meeting in November 2007. Goals of treatment are discussed with the roles of surgery, medical therapy and radiotherapy and biochemical monitoring. Suggestions are also given for ongoing clinical management/surveillance of these patients.