Hyperprolactinemia

Glezer, Andréa; Bronstein, Marcello D.

doi:10.1007/978-1-4614-8684-8_6

Cited by 3 publications

(3 citation statements)

References 40 publications

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“…Vasoactive intestinal peptide, oxytocin, galanin, and PHM-27 induce prolactin release, as does serotonin, which is thought to be the major stimulating factor accounting for the rise of prolactin during REM sleep. Conversely, glucocorticoids, thyroid hormone, GABA, and somatostatin weakly suppress prolactin secretion [1, 4, 5]. Additionally, cytokines IL-1, IL-2, and IL-6 stimulate prolactin secretion, while INFγ and endothelin-3 are inhibitory cytokines [6].…”

Section: Introductionmentioning

confidence: 99%

Stress-Induced Hyperprolactinemia: Pathophysiology and Clinical Approach

Levine

Muneyyirci-Delale

2018

Obstetrics and Gynecology International

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While prolactin is most well known for its role in lactation and suppression of reproduction, its physiological functions are quite diverse. There are many etiologies of hyperprolactinemia, including physiologic as well as pathologic causes. Physiologic causes include pregnancy, lactation, sleep-associated, nipple stimulation and sexual orgasm, chest wall stimulation, or trauma. Stress is also an important physiologic cause of hyperprolactinemia, and its clinical significance is still being explored. This review will provide an overview of prolactin physiology, the role of stress in prolactin secretion, as well as the general clinical approach to hyperprolactinemia.

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Section: Introductionmentioning

confidence: 99%

Stress-Induced Hyperprolactinemia: Pathophysiology and Clinical Approach

Levine

Muneyyirci-Delale

2018

Obstetrics and Gynecology International

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“…Prolactin values up to 200 ng/mL may be related to the intake of certain drugs or a microprolactinoma; levels >200 ng/mL are usually due to a prolactin-secreting pituitary macroadenoma. [ 7 ]…”

Section: Discussionmentioning

confidence: 99%

Persistent Idiopathic Prolactin Elevation Merits Macroprolactin Estimation

Gautam

Cherian

Jose

et al. 2021

Journal of Human Reproductive Sciences

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The prevalence of hyperprolactinemia ranges from about 0.4% in an unselected adult population to as high as 9%–17% in women with reproductive disorders. It may cause infertility in about 11% of the oligospermic males. Rarely, the cause of persistently elevated prolactin remains obscure even after thorough work up. Macroprolactinemia is biologically inactive, high-molecular-weight form of prolactin resulting from its binding to immunoglobulin G, causing a decrease in its clearance. We report the case of a 35-year-old female, detected to have hyperprolactinemia on multiple tests, during routine work up for primary infertility. Secondary causes for the same were ruled out. A magnetic resonance imaging (MRI) of the brain excluded a prolactinoma. This prompted an estimation of prolactin levels after polyethylene glycol precipitation which showed a decrease to 5.58 ng/mL, with <40% recovery, confirming the presence of macroprolactin. Thus, persistently elevated prolactin levels in the background of negative neurological imaging necessitate the estimation of macroprolactin.

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“…Since drug ingestion is a very common cause of elevated PRL levels, a careful history needs to be taken to exclude estrogen therapy, dopamine antagonists (such as metoclopramide, opioids and phenothiazines) and use of monoamine oxidase inhibitors [8]. Physiological conditions such as pregnancy and pathological conditions such as primary hypothyroidism, cirrhosis and chronic kidney disease also result in elevated PRL levels [8,72]. In most of the above conditions PRL levels rarely exceed 100 μg/L.…”

Section: Prolactinomamentioning

confidence: 99%

Secretory tumors of the pituitary gland: a clinical biochemistry perspective

Gounden

Rampursat

Jialal

2018

Clinical Chemistry and Laboratory Medicine (CCLM)

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The pituitary gland is responsible for the production and/or secretion of various hormones that play a vital role in regulating endocrine function within the body. Secretory tumors of the anterior pituitary predominantly, pituitary adenomas, collectively account for 10%–25% of central nervous system tumors requiring surgical treatment. The most common secretory tumors are prolactinomas, which can be diagnosed by basal prolactin levels. Acromegaly can be diagnosed by basal insulin growth-like factor 1 levels and the failure of growth hormone (GH) to suppress during an oral glucose tolerance test. Cushing disease can be diagnosed by demonstrating hypercortisolemia evidenced by increased salivary cortisol levels in the evening, increased urine free cortisol excretion and failure of plasma cortisol to suppress following oral dexamethasone given overnight (1.0 mg). We also discuss the diagnosis of the rarer thyroid-stimulating hormone and gonadotrophin secretory tumors. Morbidity is associated with tumor occurrence, clinical sequelae as well as the related medical, surgical and radiological management. This review focuses on the pathogenesis of secretory tumors of the anterior pituitary with emphasis on molecular mechanisms associated with tumorigenesis and the major role of the clinical chemistry laboratory in diagnosis and management of these tumors.

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Hyperprolactinemia

Cited by 3 publications

References 40 publications

Stress-Induced Hyperprolactinemia: Pathophysiology and Clinical Approach

Stress-Induced Hyperprolactinemia: Pathophysiology and Clinical Approach

Persistent Idiopathic Prolactin Elevation Merits Macroprolactin Estimation

Secretory tumors of the pituitary gland: a clinical biochemistry perspective

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