Hyperprolactinaemia

Question 1

When does hyperprolactinaemia happen normally with physiology?

Answer 1

Pregnancy

Question 2

What pathologies cause hyperprolactineamia?

Answer 2

Prolactinoma (pituitary)

Disinhibition from compression of infundibulum (loss of dopamine control)

Question 3

Symptoms of hyperprolactineamia?

Answer 3

Amenorrhoea

Oligomenorrhoea

Decreased libido

Weight gain

Milk ejection

Question 4

What is amenorrhoea?

Answer 4

Absence of periods

Question 5

What is oligomenorrhoea?

Answer 5

Infrequent periods

Question 6

Tests?

Answer 6

Prolactin levels

Pregnancy test

TFTs

MRI Pituitary

Question 7

What indicates a prolactinoma cause?

Answer 7

The higher the PRL level the more indicative of prolactinoma

Question 8

What is the first line of treatment?

Answer 8

Dopamine agonist

- Bromocriptine

Question 9

What effect will a dopamine agonist have on the tumour?

Answer 9

Will shrink it

Question 10

What management should be done if the tumour is unresponsive to dopamine agonists?

Answer 10

Trans-sphenoidal surgery

Question 11

What other symptoms indicate trans-sphenoidal surgery?

Answer 11

Visual symptoms from chiasmal compression