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Hyperprolactinemia

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  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. Treat with 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 (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)
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.
ConceptsDisease or Syndrome (T047)
MSHD006966
EnglishHYPERPROLACTINAEMIA, Hyperprolactinemia, Hyperprolactinemias, INAPPROPRIATE PROLACTIN SECRET, INAPPROPRIATE PROLACTIN SECRET SYNDROME, Inappropriate Prolactin Secretion, Inappropriate Prolactin Secretion Syndrome, Inappropriate Secretion Prolactin, PROLACTIN HYPERSECRET SYNDROME, Prolactin Hypersecretion Syndrome, PROLACTIN INAPPROPRIATE SECRET
Spanishhiperprolactinemia, hipersecrecion de prolactina
Parent ConceptsHyperpituitarism (C0020506), Pituitary Diseases (C0032002), Metabolic Diseases (C0025517), Duplicate concept (C1274013)
SourcesAOD, COSTAR, CSP, CST, DXP, MSH, MTH, NDFRT, OMIM, SCTSPA, SNOMEDCT
Derived from the NIH UMLS (Unified Medical Language System)



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