Prolactinoma differential diagnosis: Difference between revisions

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==Differential Diagnosis==
==Differential Diagnosis==
Prolactinoma must be differentiated from other diseases that cause hyperprolactinemia including:
Prolactinoma must be differentiated from other diseases that cause hyperprolactinemia including:
*[[Prescription drugs]]: antipsychotic medications Prolactin secretion in the pituitary is normally suppressed by the brain chemical dopamine.  Drugs that block the effects of dopamine at the pituitary or deplete [[dopamine]] stores in the brain may cause the [[pituitary]] to secrete [[prolactin]].  These drugs include older such as trifluoperazine (Stelazine) and [[haloperidol]] (Haldol); the newer antipsychotic drugs risperidone (Risperdal) and molindone (Moban); metoclopramide (Reglan), used to treat gastroesophageal reflux and the nausea caused by certain cancer drugs; and less often, verapamil, alpha-methyldopa (Aldochlor, Aldoril), and reserpine (Serpalan, Serpasil), used to control high blood pressure.  Some antidepressants may cause hyperprolactinemia, but further research is needed<ref>http://www.niddk.nih.gov/health-information/health-topics/endocrine/prolactinoma/Pages/fact-sheet.aspx</ref>.
*[[Prescription drugs]]:  
*[[Pituitary tumors]] other than prolactinoma. Other tumors arising in or near the pituitary may block the flow of dopamine from the brain to the prolactin-secreting cells.  Such tumors include:
**[[Somatotroph adenoma]]<ref>Levy A: Pituitary disease: presentation, diagnosis, and management. J Neurol Neurosurg Psychiatry 75 (Suppl 3): iii47-52, 2004. [PUBMED Abstract]</ref>: It results in [[acromegaly]], a condition caused by excessive growth hormone
**Corticotroph adenoma: It results in [[Cushing's syndrome]], caused by excessive [[cortisol]].
Other pituitary tumors that do not result in excess hormone production may also block the flow of [[dopamine]].
*[[Hypothyroidism]]. Increased prolactin levels are often seen in people with hypothyroidism, a condition in which the [[thyroid]] does not produce enough thyroid hormone. Physicians  routinely test people with hyperprolactinemia for [[hypothyroidism]].
*Chest involvement. Nipple stimulation also can cause a modest increase in the amount of prolactin in the blood.  Similarly, chest wall injury or shingles involving the chest wall may also cause hyperprolactinemia.


*Normal pregnancy.
:*[[Antipsychotic]] medications
 
:**[[Trifluoperazine]]
 
:**[[Haloperidol]]
 
:**[[Risperidone]]
 
:**[[molindone]]
 
:**[[metoclopramide]]
*[[Pituitary tumors]] other than prolactinoma.
**[[Somatotroph adenoma]]<ref>Levy A: Pituitary disease: presentation, diagnosis, and management. J Neurol Neurosurg Psychiatry 75 (Suppl 3): iii47-52, 2004. [PUBMED Abstract]</ref>: [[acromegaly]]
**Corticotroph adenoma: [[Cushing's syndrome]]
*[[Hypothyroidism]].
*Normal [[pregnancy]].


== References ==
== References ==

Revision as of 13:39, 11 September 2015

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Overview

Prolactinoma must be differentiated from other diseases that cause hyperprolactinemia including hypothyroidism and side effects of medications including antipsychotics and antidepressants.

Differential Diagnosis

Prolactinoma must be differentiated from other diseases that cause hyperprolactinemia including:

References

  1. ↑ Levy A: Pituitary disease: presentation, diagnosis, and management. J Neurol Neurosurg Psychiatry 75 (Suppl 3): iii47-52, 2004. [PUBMED Abstract]


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