Sandbox:Mydah
Associate Editor(s)-in-Chief: Mydah Sajid, MD[1]
Hyperprolactinemia resident survival guide
Overview
This section provides a short and straight to the point overview of the hyperprolactinemia.
Causes
Life-threatening Causes
Life-threatening causes include conditions that may result in death or permanent disability within 24 hours if left untreated.
- Severe burns on the chest can cause hyperprolactinemia due to neural stimulation similar to suckling. [1]
Common Causes
- Pregnancy
- Lactation
- Prolactinoma
- Injury to dopaminergic neurons in the hypothalamus (sarcoidosis, craniopharyngioma, and metastatic brain carcinoma)
- Section of the hypothalamic-pituitary stalk
- Antipsychotics (risperidone, haloperidol, and phenothiazine)
- Selective serotonin reuptake inhibitors
- Metoclopramide
- Domperidone
- Methyldopa
- Verapamil
- Familial hyperprolactinemia
- Hypothyroidism
- Chronic renal failure
- macroprolactinomas
- Exercise
Evaluation
Shown below is an algorithm summarizing the diagnosis of hyperprolactinemia according to an Endocrine Society Clinical Practice guidelines:
Suggestive symptoms including headache, oligomenorrhea, infertility, hypogonadism, erectile dysfunction, and galactorrhea | |||||||||||||||||||
Detailed history and physical examination should be performed to rule out hypothyroidism, chronic renal failure, and the use of medications known to cause hyperprolactinemia. | |||||||||||||||||||
Serum prolactin measured. The cut-off values of serum prolactin for hyperprolactinemia are greater than 20 ng/ml in men and postmenopausal women and greater than 30ng/ml in premenopausal women. | |||||||||||||||||||
MRI with the contrast of brain should be performed to rule out any mass in the hypothalamic-pituitary region. | |||||||||||||||||||
The levels of other pituitary hormones should be evaluated. The following hormone levels should be evaluated: Plasma corticotropins (ACTH), Serum TSH, Insulin-like growth factors, Follicle-stimulating hormone, Luteinizing hormone, Estradiol/ Testosterone | |||||||||||||||||||
References
- ↑ Morley JE, Dawson M, Hodgkinson H, Kalk WJ (1977). "Galactorrhea and hyperprolactinemia associated with chest wall injury". J Clin Endocrinol Metab. 45 (5): 931–5. doi:10.1210/jcem-45-5-931. PMID 562902.