Endocrine Abstracts

Introduction: 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. Factitious hypoglycemia a rare case of induced hyperprolactinemia

Case report: We report a case of 17-years-old girl presented to with sever hypoglycemia mesured at 30 mg/dl. The patient had no significant medical personal history, and she had a younger sister with type 1 diabetes mellitus. Physical examination of the patient showed: weight of 44 kg, BMI = 20 kg/m² and bilateral induced galactorrhea with no other abnormalities. Laboratory analysis revealed normal renal and hepatic function and confirmed the exogenous injection of insulin with hyperinsulinism at 191uUI/ml and low C-peptid level 0.71 ng/ml concomitant to hypoglycemia at 37 mg/dl. Endocrine studies were notable for high levels of prolactin 3063 mUI/ml (102–496 mUI/ml), normal adrenal gland function (cortisol = 512 nmol/l after Synacthen test) and normal thyroid hormones level (TSH = 0.67 uUI/ml and FT4 = 17.95 pmol/l). Magnetic resonance imaging of the pituitary gland was done and showed no abnormalities. The patient was referred to psychiatric evaluation and management. On follow up she had no recurrent episodes of hypoglycemia, she had no more galactorrehea and prolactin level returned to normal in 3 weeks (prolactin = 370 mUI/ml).

Conclusion: It is known that are many physiologic and pathologic causes of hyperprolactinemia. Stress is an important physiologic cause of hyperprolactinemia, and its clinical significance is still being explored. We report a rare case of factitious hypoglycemia as cause of stress-induced hyperprolactinemia.