Endocrine Abstracts

Hyperprolactinaemia is a common endocrine disorder. Causes are related to physiological factors, pharmacological intervention and pathological conditions. There are a wide variety of drugs that can induce a significant hyperprolactinaemia frequently associated with clinical symptoms. The aim was to analyse clinical manifestation of hyperprolactinaemia in routine clinical practice.

Material and methods: We conducted retrospective review of medical records of patients with hyperprolactinaemia (serum prolactin concentration >1000 mIU/l) treated at Vilnius Antakalnio outpatient clinic in 2011–2014. Pregnant and lactating women and patients with macroprolactin were excluded. We recorded demographic data, medical history, LH, FSH, TTH, LT4, anti-TPO concentration and MRI results.

Results: We analysed data of 68 patients (4.4% male and 95.6% female). Mean age was 31.60±9.23 years. Mean prolactin concentration was 1448.75±526.78 mIU/l. Irregular cycles were observed in 48.5% of women, galactorrhoea in 20.6%, infertility in 20.6%. Headache was present in 17.6% of patients, body weight gain in 13.2%. The most frequent concomitant diseases were thyroid disorders (41.2%), mental illnesses, including usage of antidepressants or neuroleptics (14.7%) and polycystic ovary syndrome (7.4%). 76.4% of patients were treated with dopamine agonists (bromocriptine or cabergoline). 50.0% of the patients underwent MRI: pituitary microadenoma was diagnosed in 13 patients, macroadenoma in 2, empty sella syndrome in 1 and pituitary cyst in 1. MRI results of 17 patients didn’t show any pathology. Patients with pituitary pathology were older than those with normal MRI results (35.35±9.41 vs. 27.88±8.14 years, P=0.012). There was no difference in prolactin concentration, frequency of complains, BMI, underlying diseases and hormone concentration between groups. In a group of patients without pituitary pathology anti-TPO was associated with prolactin level (r=0.900, P=0.037).

Conclusion: Main clinical manifestation of hyperprolactinaemia was menstrual irregularity, galactorrhoea and headache. In routine practice up to 50% of hyperprolactinaemia cases were associated with causes other than pituitary tumours.