Prolactinoma differential diagnosis: Difference between revisions

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==Overview==
==Overview==
[[Prolactinoma]] must be differentiated from other causes of hyperprolactinemia such as [[hypothyroidism]], [[antipsychotics]] and [[antidepressants]].
[[Prolactinoma]] must be differentiated from other causes of [[hyperprolactinemia]].
 
Causes of [[hyperprolactinemia]] can be categorized as [[physiological]], [[pathological]] and [[medication-induced]].


==Differential Diagnosis==
==Differential Diagnosis==
Prolactinoma must be differentiated from other causes of hyperprolactinemia including:
[[Prolactinoma]] must be differentiated from other causes of [[hyperprolactinemia]] including:
*[[Pituitary tumors]] (other than prolactinoma)<ref name="pmid15316045">{{cite journal| author=Levy A| title=Pituitary disease: presentation, diagnosis, and management. | journal=J Neurol Neurosurg Psychiatry | year= 2004 | volume= 75 Suppl 3 | issue=  | pages= iii47-52 | pmid=15316045 | doi=10.1136/jnnp.2004.045740 | pmc=PMC1765669 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15316045  }} </ref>
#'''[[Physiological]]:'''
**[[Somatotroph adenoma]]: [[Acromegaly]]
#*Normal [[pregnancy]]<ref name="pmid910825">{{cite journal| author=Rigg LA, Lein A, Yen SS| title=Pattern of increase in circulating prolactin levels during human gestation. | journal=Am J Obstet Gynecol | year= 1977 | volume= 129 | issue= 4 | pages= 454-6 | pmid=910825 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=910825  }} </ref>
**Corticotroph adenoma: [[Cushing's syndrome]]
#'''[[Pathological]]:'''
*[[Hypothyroidism]]
#*[[Pituitary tumors]] (other than prolactinoma):<ref name="pmid15316045">{{cite journal| author=Levy A| title=Pituitary disease: presentation, diagnosis, and management. | journal=J Neurol Neurosurg Psychiatry | year= 2004 | volume= 75 Suppl 3 | issue=  | pages= iii47-52 | pmid=15316045 | doi=10.1136/jnnp.2004.045740 | pmc=1765669 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15316045  }} </ref>
*Normal [[pregnancy]]
#**[[Somatotroph adenoma]]: [[Acromegaly]]
*[[Seizure|Seizure disorder]]
#**[[ACTH-secreting tumor|Corticotroph adenoma]]: [[Cushing's syndrome]]
*Adverse effects of [[antipsychotic]] medications:
#*Supra [[Sella turcica|seller]] tumors(tumors present in region of [[pituitary stalk]])
**[[Trifluoperazine]]
#*[[Hypothyroidism]]<ref name="pmid4199418">{{cite journal| author=Snyder PJ, Jacobs LS, Utiger RD, Daughaday WH| title=Thyroid hormone inhibition of the prolactin response to thyrotropin-releasing hormone. | journal=J Clin Invest | year= 1973 | volume= 52 | issue= 9 | pages= 2324-9 | pmid=4199418 | doi=10.1172/JCI107421 | pmc=333037 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=4199418  }} </ref>
**[[Haloperidol]]
#*[[Chronic renal failure]]<ref name="pmid7372775">{{cite journal| author=Sievertsen GD, Lim VS, Nakawatase C, Frohman LA| title=Metabolic clearance and secretion rates of human prolactin in normal subjects and in patients with chronic renal failure. | journal=J Clin Endocrinol Metab | year= 1980 | volume= 50 | issue= 5 | pages= 846-52 | pmid=7372775 | doi=10.1210/jcem-50-5-846 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=7372775  }} </ref>
**[[Risperidone]]
#*[[Hepato-biliary diseases|Liver disease]]<ref name="pmid26958514">{{cite journal| author=Jha SK, Kannan S| title=Serum prolactin in patients with liver disease in comparison with healthy adults: A preliminary cross-sectional study. | journal=Int J Appl Basic Med Res | year= 2016 | volume= 6 | issue= 1 | pages= 8-10 | pmid=26958514 | doi=10.4103/2229-516X.173984 | pmc=4765284 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26958514  }} </ref>
**[[Molindone]]
#**[[Cirrhosis]](with or without [[encephalopathy]])
**[[Metoclopramide]]
#**[[Viral hepatitis]](with [[encephalopathy]])
#*[[Seizure|Seizure disorder]]<ref name="Ben-Menachem2006">{{cite journal|last1=Ben-Menachem|first1=Elinor|title=Is Prolactin a Clinically Useful Measure of Epilepsy?|journal=Epilepsy Currents|volume=6|issue=3|year=2006|pages=78–79|issn=1535-7597|doi=10.1111/j.1535-7511.2006.00104.x}}</ref>
#'''[[Medication-induced]]:'''
#*[[Antipsychotic]] medications:<ref name="pmid11048906">{{cite journal| author=David SR, Taylor CC, Kinon BJ, Breier A| title=The effects of olanzapine, risperidone, and haloperidol on plasma prolactin levels in patients with schizophrenia. | journal=Clin Ther | year= 2000 | volume= 22 | issue= 9 | pages= 1085-96 | pmid=11048906 | doi=10.1016/S0149-2918(00)80086-7 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11048906  }} </ref>
#**[[Haloperidol]]
#**[[Risperidone]]
#*[[Antiemetic]] medications:
#**[[Metoclopramide]]<ref name="pmid777023">{{cite journal| author=McCallum RW, Sowers JR, Hershman JM, Sturdevant RA| title=Metoclopramide stimulates prolactin secretion in man. | journal=J Clin Endocrinol Metab | year= 1976 | volume= 42 | issue= 6 | pages= 1148-52 | pmid=777023 | doi=10.1210/jcem-42-6-1148 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=777023  }} </ref>
#**[[Domperidone]]<ref name="pmid7037817">{{cite journal| author=Sowers JR, Sharp B, McCallum RW| title=Effect of domperidone, an extracerebral inhibitor of dopamine receptors, on thyrotropin, prolactin, renin, aldosterone, and 18-hydroxycorticosterone secretion in man. | journal=J Clin Endocrinol Metab | year= 1982 | volume= 54 | issue= 4 | pages= 869-71 | pmid=7037817 | doi=10.1210/jcem-54-4-869 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=7037817  }} </ref>
#*[[Antihypertensive]] medications:
#**[[Methyldopa]]<ref name="pmid1268617">{{cite journal| author=Steiner J, Cassar J, Mashiter K, Dawes I, Fraser TR, Breckenridge A| title=Effects of methyldopa on prolactin and growth hormone. | journal=Br Med J | year= 1976 | volume= 1 | issue= 6019 | pages= 1186-8 | pmid=1268617 | doi= | pmc=1639736 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=1268617  }} </ref>
#**[[Verapamil]]<ref name="pmid6682619">{{cite journal| author=Fearrington EL, Rand CH, Rose JD| title=Hyperprolactinemia-galactorrhea induced by verapamil. | journal=Am J Cardiol | year= 1983 | volume= 51 | issue= 8 | pages= 1466-7 | pmid=6682619 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=6682619  }} </ref>
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!Investigation of Choice
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== References ==
== References ==

Revision as of 16:48, 20 July 2017

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Anmol Pitliya, M.B.B.S. M.D.[2]

Overview

Prolactinoma must be differentiated from other causes of hyperprolactinemia.

Causes of hyperprolactinemia can be categorized as physiological, pathological and medication-induced.

Differential Diagnosis

Prolactinoma must be differentiated from other causes of hyperprolactinemia including:

  1. Physiological:
  2. Pathological:
  3. Medication-induced:
Disease Clinical Findings Investigation of Choice Management

References

  1. ↑ Rigg LA, Lein A, Yen SS (1977). "Pattern of increase in circulating prolactin levels during human gestation". Am J Obstet Gynecol. 129 (4): 454–6. PMID 910825.
  2. ↑ Levy A (2004). "Pituitary disease: presentation, diagnosis, and management". J Neurol Neurosurg Psychiatry. 75 Suppl 3: iii47–52. doi:10.1136/jnnp.2004.045740. PMC 1765669. PMID 15316045.
  3. ↑ Snyder PJ, Jacobs LS, Utiger RD, Daughaday WH (1973). "Thyroid hormone inhibition of the prolactin response to thyrotropin-releasing hormone". J Clin Invest. 52 (9): 2324–9. doi:10.1172/JCI107421. PMC 333037. PMID 4199418.
  4. ↑ Sievertsen GD, Lim VS, Nakawatase C, Frohman LA (1980). "Metabolic clearance and secretion rates of human prolactin in normal subjects and in patients with chronic renal failure". J Clin Endocrinol Metab. 50 (5): 846–52. doi:10.1210/jcem-50-5-846. PMID 7372775.
  5. ↑ Jha SK, Kannan S (2016). "Serum prolactin in patients with liver disease in comparison with healthy adults: A preliminary cross-sectional study". Int J Appl Basic Med Res. 6 (1): 8–10. doi:10.4103/2229-516X.173984. PMC 4765284. PMID 26958514.
  6. ↑ Ben-Menachem, Elinor (2006). "Is Prolactin a Clinically Useful Measure of Epilepsy?". Epilepsy Currents. 6 (3): 78–79. doi:10.1111/j.1535-7511.2006.00104.x. ISSN 1535-7597.
  7. ↑ David SR, Taylor CC, Kinon BJ, Breier A (2000). "The effects of olanzapine, risperidone, and haloperidol on plasma prolactin levels in patients with schizophrenia". Clin Ther. 22 (9): 1085–96. doi:10.1016/S0149-2918(00)80086-7. PMID 11048906.
  8. ↑ McCallum RW, Sowers JR, Hershman JM, Sturdevant RA (1976). "Metoclopramide stimulates prolactin secretion in man". J Clin Endocrinol Metab. 42 (6): 1148–52. doi:10.1210/jcem-42-6-1148. PMID 777023.
  9. ↑ Sowers JR, Sharp B, McCallum RW (1982). "Effect of domperidone, an extracerebral inhibitor of dopamine receptors, on thyrotropin, prolactin, renin, aldosterone, and 18-hydroxycorticosterone secretion in man". J Clin Endocrinol Metab. 54 (4): 869–71. doi:10.1210/jcem-54-4-869. PMID 7037817.
  10. ↑ Steiner J, Cassar J, Mashiter K, Dawes I, Fraser TR, Breckenridge A (1976). "Effects of methyldopa on prolactin and growth hormone". Br Med J. 1 (6019): 1186–8. PMC 1639736. PMID 1268617.
  11. ↑ Fearrington EL, Rand CH, Rose JD (1983). "Hyperprolactinemia-galactorrhea induced by verapamil". Am J Cardiol. 51 (8): 1466–7. PMID 6682619.

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