Endocrine Abstracts

Introduction: Hyperprolactinemia is a condition of elevated prolactin levels in blood which could be physiological, pathological, or idiopathic in origin. Some cases of hyperprolactinemia have been reported in patients with renal failure. We present a case of hyperprolactinemia, thyrotropic and corticotropic insufficiency in a patient with end-stage renal failure.

Case presentation: The patient was 27 years old, with a history of hypertension, renal insufficiency at the stage of haemodialysis, tertiary hyperparathyroidism and thyrotropic insufficiency. She was admitted to our endocrinology’s department, in October 2021, for further exploration of the other pituitary axes. She had no functional complaints. The physical examination showed a weight of 49 kg with a body mass index of 20.3 kg/m². BP was 150/80 mmHg and there were galactorrhea on breast examination.

The biological investigations showed :

- Thyrotropic insufficiency : TSH : 0.099 mUI/l [usual values : 0.35-4.95]; FT4 : 0.69 ng/dl; FT3 :2,39 pg/ml [usual values:1.71-3.71];

- FSH :4.8 UI/l, LH :45.31 UI/l;

- Hyperprolactinemia was confirmed PRL : 229.66 and 255.03 mg/l

- Testosterone : 2.04 mmol/l;

- PTH : 1877.8 ng/dl [15-68]; Calcemia : 2.46 mmol/l

- A corticotropic insufficiency had been confirmed by a hypoglycemia test, and a treatment by hydrocortisone was started.

A Hypothalamic pituitary MRI was performed and showed no abnormalities.

Conclusion: This case confirmed that pituitary function is abnormal in patients receiving haemodialysis. Hyperprolactinemia is common and may be a factor in the infertility and sexual dysfunction in patients with end-stage renal disease.