Epidemiological and clinical profiles of Saudi patients with hyperprolactinemia in a single tertiary care center

Abstract

BACKGROUND: Prolactin is a hormone of the pituitary gland whose main function is the production of milk. Hyperprolactinemia is defined as an increase in prolactin levels above 25 μg/L in women and 20 μg/L in men. Causes of hyperprolactinemia include pituitary tumors, especially prolactinomas. Hyperprolactinemia can manifest clinically with a variety of symptoms, including galactorrhea and menstrual irregularities in women and erectile dysfunction in men. There are limited data on the epidemiology of hyperprolactinemia in the Middle East region. OBJECTIVES: Description of the epidemiology and clinical features of hyperprolactinemia in a cohort from Saudi Arabia. DESIGN: Medical record review SETTING: Tertiary medical center in Riyadh PATIENTS AND METHODS: The study included adult patients with hyperprolactinemia in King Abdulaziz Medical City in Riyadh. The patients were treated in endocrinology clinics from 2015 to 2019. Patients of both sexes older than 14 years were enrolled in the study. Patients with insufficient follow-up were excluded. Data were collected on demographic characteristics, symptoms, prolactin level, cause of high prolactin level, and treatment. MAIN OUTCOME MEASURES: The frequency of different etiologies and symptoms in patients with hyperprolactinemia. SAMPLE SIZE: 295 patients RESULTS: The majority of patients with hyperprolactinemia were female 256 (86.8%). Hyperprolactinemia was diagnosed more frequently in patients in the age groups 21–30 years (42.6%) and 31–40 years (24.1%). The majority of the study population was obese or overweight: 136 (46.3%) and 74 (25.2%), respectively. Most of the cases were symptomatic (192, 65.1%). In women, the most common symptom was oligomenorrhea (35%). In men, infertility and erectile dysfunction were the most common clinical symptoms (50% and 44.7%, respectively). Idiopathic causes were the most common etiology (108, 36.6%), followed by pituitary adenomas (81, 27.5%). The majority of patients were treated (184,62.4%), with cabergoline being the most commonly used medication (173, 94.0%). CONCLUSION: The demographic and clinical presentations and causes of hyperprolactinemia in male and female Saudi patients were similar to that in studies in other populations. LIMITATIONS: Single-center retrospective chart review study. CONFLICT OF INTEREST: None.

Mild hyperprolactinemia in clinical practice: the diagnostic “traps” and treatment strategy

“…В одноцентровом исследовании M. Mahzari и соавт. средний уровень пролактина в момент диагностики составил 1185 мЕд/мл, что свидетельствует о высокой распространенности умеренной гиперпролактинемии [28]. Клиническая симптоматика у пациентов в этом исследовании также не различалась в зависимости от уровня пролактина [29].…”

“…M. Mahzari и соавт. при оценке нозологической структуры гиперпролактинемии зарегистрировали сходную частоту первичного гипотиреоза и макропролактинемии как причин повышения уровня пролактина [28]. Клинические рекомендации строго предписывают исключать первичный гипотиреоз при выявлении гиперпролактинемии, однако остается дискуссионным вопрос: молекулярные фракции пролактина нужно исследовать всегда или только при определенных условиях?…”

HES1 induces ITPR1-mediated autophagy to exert anti-metastatic effects in pituitary adenomas

“…Different hormonal types of PA can manifest a variety of symptoms, often due to excessive hormone secretion ( 2 ). For instance, prolactinomas can lead to menstrual irregularities and galactorrhea in females, and impotence in males ( 7 ). Adenomas that secrete growth hormone can result in acromegaly, marked by enlarged limbs, altered facial features, and skin changes ( 8 ).…”