HYPERPROLACTINAEMIA Flashcards
WHAT IS HYPERPROLACTINAEMIA?
- high levels of prolactin
WHAT SHOULD BE EXLCUDED BEFORE FURTHER INVESTIGATIONS WHEN HYPERPROLACTINAEMIA IS PRESENTED?
- pregnancy
WHAT MEDICATIONS CAN CAUSE HIGH PROLACTIN LEVELS?
- antipsychotics such as haloperidol (DA antagonist)
- anti-emetics such as metoclopramide (DA antagonist)
Drugs act to decrease dopamine levels, preventing its inhibitory effects on prolactin release.
WHAT MEDICAL CONDITIONS CAN LEAD TO HYPERPROLACTINAEMIA?
1) Prolactinoma
2) Polycystic ovary syndrome
3) Hypothyroidism
WHAT IS A PROLACTINOMA?
non- cancerous tumour (benign) of the pituitary gland leading to active secretion of prolactin
WHAT IS MICRO-PROLACTINAEMIA?
- most common
- occur mainly in women
- <1 cm
WHAT DO MICRO-PROLACTINAEMIAS PRESENT WITH?
- menstrual disturbance
- infertility
- galactorrhoea (excessive or inappropriate milk production)
HOW DO YOU DISTINGUISH BETWEEN PCOS AND MICRO-PROLACTINAEMIA?
- presence of androgenic symptoms, less elevated prolactin levels and absence of pituitary lesion on MRI
- hirsutism (excess facial or body hair), acne or oily skin
WHAT ARE MACRO-PROLACTINOMAS?
- > 1 cm
- prolactin levels > 5000 miU
- more common in men than women
WHAT IS THE TREATMENT FOR HYPERPROLACTINOMA?
1) Cabergoline/ bromocriptine (D2 agonists)
WHAT ARE THE COMMON SIDDE EFFECTS ASSOCIATED WITH D2 AGONIST?
- nausea
- postural hypotension
- psychiatric disturbance - rarely
WHAT ARE PHYSIOLOGICAL CAUSES OF HYPERPROLACTINAEMIA?
- pregnancy
- breast stimulation
- stress
WHAT ARE PITUIATARY CAUSES OF HYPERPROLACTINAEMIA?
- prolactinoma
- non-functioning adenoma
- stalk secretion
WHAT ARE SECONDARY CAUSES OF HYPERPROLACTINAEMIA?
- renal failure
- primary hypothyroidism
- adrenal insufficiency
- PCOS
