Endocrinology Book

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Hyperprolactinemia

Aka: Hyperprolactinemia
  1. Causes
    1. See Hyperprolactinemia Causes
    2. Medication Causes of Hyperprolactinemia
  2. Symptoms
    1. Galactorrhea
    2. Amenorrhea
    3. Infertility
  3. Approach: Initial Evaluation
    1. Confirm Hyperprolactinemia
      1. Repeat Serum Prolactin
      2. Repeat in 6 months if repeat Prolactin normal
    2. Evaluate for Physiologic Cause
      1. History
        1. Breast stimulation
        2. Sexual Intercourse temporally related to lab test
        3. Excessive Eating, Exercise, Sleep or Stress
      2. Labs
        1. Thyroid Stimulating Hormone (Hypothyroidism)
        2. Urine Pregnancy Test
  4. Approach: Prolactin 20 to 50 ng/ml
    1. Identify medication related Hyperprolactinemia cause
      1. Discontinue Medication Causes of Hyperprolactinemia
      2. Repeat Prolactin in 1-2 months
    2. No obvious medication cause
      1. Recheck serum Prolactin in 3 months
      2. Consider lab testing as above (e.g. TSH, HCG)
  5. Approach: Prolactin 50 to 100 ng/ml
    1. Identify medication related Hyperprolactinemia cause
      1. Discontinue offending medication
      2. Repeat Prolactin in 1-2 months
    2. No obvious medication cause
      1. Obtain CT or MRI Head (cone-down sella turcica)
      2. Imaging Normal
        1. Amenorrhea or Infertility present
          1. Consider Bromocriptine
        2. Normal Menses and fertility
          1. Repeat Prolactin at 6 month intervals
          2. Repeat CT or MRI Head (cone-down sella) in 1 year
      3. Imaging Abnormal
        1. Evaluate Pituitary Tumor (see Prolactinoma)
  6. Approach: Prolactin >100 ng/ml
    1. Causes
      1. Empty sella syndrome
      2. Pituitary adenoma (especially if >200)
    2. Obtain CT or MRI Head (cone-down sella turcica)
      1. Imaging Abnormal
        1. Evaluate Pituitary Tumor (see Prolactinoma)
      2. Imaging Normal
        1. Treat with Bromocriptine
        2. Repeat Serum Prolactin every 3 months
        3. Repeat CT or MRI Head (cone-down sella) in 1 year

Hyperprolactinemia (C0020514)

Definition (CSP) increased levels of prolactin in the blood, which may be associated with amenorrhea and galactorrhea; relatively common etiologies include prolactinoma, medication effect, kidney failure, granulomatous diseases of the pituitary gland, and disorders which interfere with the hypothalamic inhibition of prolactin release; ectopic (non-pituitary) production of prolactin may also occur.
Definition (MSH) Increased levels of PROLACTIN in the BLOOD, which may be associated with AMENORRHEA and GALACTORRHEA. Relatively common etiologies include PROLACTINOMA, medication effect, KIDNEY FAILURE, granulomatous diseases of the PITUITARY GLAND, and disorders which interfere with the hypothalamic inhibition of prolactin release. Ectopic (non-pituitary) production of prolactin may also occur. (From Joynt, Clinical Neurology, 1992, Ch36, pp77-8)
Concepts Disease or Syndrome (T047)
MSH D006966
ICD10 E22.1
SnomedCT 367422005, 190468001, 237662005, 21170004
English Hyperprolactinemias, HYPERPROLACTINAEMIA, HYPERPROLACTINEMIA, Hyperprolactinaemia, NOS, Hyperprolactinemia, NOS, INAPPROPRIATE PROLACTIN SECRET SYNDROME, PROLACTIN HYPERSECRET SYNDROME, INAPPROPRIATE PROLACTIN SECRET, PROLACTIN INAPPROPRIATE SECRET, hyperprolactinemia (diagnosis), hyperprolactinemia, Idiopathic hyperprolactinemia (disorder), Idiopathic hyperprolactinemia [dup], Idiopathic hyperprolactinemia, Hyperprolactinaemia (disorder), Hyperprolactinemia, Hypersecretion Syndrome, Prolactin, Prolactin Hypersecretion Syndrome, Syndrome, Prolactin Hypersecretion, Inappropriate Prolactin Secretion, Inappropriate Secretion Prolactin, Prolactin Secretion, Inappropriate, Prolactin, Inappropriate Secretion, Secretion Prolactin, Inappropriate, Secretion, Inappropriate Prolactin, Inappropriate Prolactin Secretion Syndrome, Hyperprolactinemia [Disease/Finding], Hyperprolactinaemia, Hyperprolactinemia (disorder), hyperprolactinaemia
French HYPERPROLACTINEMIE, Hyperprolactinémie, Syndrome de sécrétion inappropriée d'hormone lutéotrope, Syndrome de sécrétion inappropriée de LTH, Syndrome de sécrétion inappropriée de PRL, Syndrome de sécrétion inappropriée de prolactine
Portuguese HIPERPROLACTINEMIA, Hiperprolactinemia, Secreção Inadequada de Prolactina, Síndrome da Hipersecrecão de Prolactina
Spanish HIPERPROLACTINEMIA, Hyperprolactinaemia, Hyperprolactinemia, hiperprolactinemia (concepto no activo), hiperprolactinemia (trastorno), hiperprolactinemia, hipersecreción de prolactina, Hiperprolactinemia, Secreción Inapropiada de Prolactina, Síndrome de Hipersecreción de Prolactina, Secrecion Inapropiada de Prolactina, Sindrome de Hipersecrecion de Prolactina
German HYPERPROLAKTINAEMIE, Hyperprolactinaemie, Hyperprolaktinaemie, Prolaktin-Hypersekretionssyndrom, Hyperprolaktinämie, Prolaktinämie, Hyper-, Prolaktin, inadäquate Sekretion
Swedish Hyperprolaktinemi
Japanese ｺｳﾌﾟﾛﾗｸﾁﾝｹﾂｼｮｳ, ｺｳﾌﾟﾛﾗｸﾁﾝｹｯｼｮｳ, 過プロラクチン血症, 高プロラクチン血症, 高プロラクチン血
Czech hyperprolaktinémie, Hyperprolaktinemie
Finnish Hyperprolaktinemia
Russian GIPERPROLAKTINEMIIA, ГИПЕРПРОЛАКТИНЕМИЯ
Italian Secrezione inappropriata di prolattina, Iperprolattinemia
Korean 고프로락틴혈증
Croatian HIPERPROLAKTINEMIJA
Polish Hiperprolaktynemia, Nadmierne wydzielanie prolaktyny
Hungarian Hyperprolactinaemia
Dutch hyperprolactinemie, Hyperprolactinemie, Prolactinehypersecretiesyndroom, Prolactinemie, hyper-, Prolactinesecretie, inadequate
Sources
Derived from the NIH UMLS (Unified Medical Language System)


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