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Pathology
Elevated prolactin levels
Aetiology
Physiological: Stress, pregnancy, breast feeding
Drugs: Methyldopa, metoclopramide, haloperidol, oestrogen
Malignancy: Microprolactinoma (<10mm diameter) or Macroprolactinoma
(>10mm diameter)
Signs
Visual defects
Symptoms
Reduced/absent menstruation, galactorrhoea, breast tenderness, headaches, lack of libido, sub-fertility, erectile dysfunction.
Investigations
Bloods: Serum prolactin, pituitary function, TFTs,
Special tests: Visual field assessment
Imaging: MRI pituitary.Treatment
Medical: Stop offending drugs, Dopamine agonist therapy with bromocriptine or
cabergoline to normalise prolactin if malignancy
Surgical: Trans-sphenoidal surgery
Prognosis
Usually good prognosis
Osteoporosis
Key Facts
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Key Images
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Key References
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