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Hyperprolactinemia

D’Ann Somerall, DNP, MAEd, CRNP, FNP-BC and William E. Somerall, Jr., MD, MEd Reviewed 06/2020
 


BASICS

DESCRIPTION

Hyperprolactinemia is an abnormal elevation in the serum prolactin level, from either physiologic or pathologic influences of the lactotroph cells of the pituitary gland 

EPIDEMIOLOGY

Prevalence

DIAGNOSIS

HISTORY

  • Galactorrhea

  • Amenorrhea

  • Oligomenorrhea

  • Infertility

  • Osteoporosis/osteopenia

  • Decreased libido, impotence

  • Weight gain

  • Also may have signs and symptoms of pituitary enlargement:

    • Headache

    • Visual fi...

TREATMENT

GENERAL MEASURES

  • Discontinue offending medications, if any (3)[A].

  • Treat underlying causes (3)[A].

  • For asymptomatic patients with mild prolactin elevations, observation alone may be considered ...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

Reevaluate lab levels after 1 month; if normal, continue the initial dose. If lab levels do not decrease, but patient experiences no side effects, increase cabber...

REFERENCES

1
Casanueva FF, Molitch ME, Schlechte JA, et al. Guidelines of the Pituitary Society for the diagnosis and management of prolactinomas. Clin Endocrinol (Oxf).  2006;65(2):265–273.
2
Inder...

ADDITIONAL READING

  • Klibanski A. Clinical practice. Prolactinomas. N Engl J Med.  2010;362(13):1219–1226.

  • Melmed S, Casanueva FF, Hoffman AR, et al. Diagnosis and treatment of hyperprolactinemia: a...

CODES

ICD10

E22.1 Hyperprolactinemia 

ICD9

253.1 Other and unspecified anterior pituitary hyperfunction 

SNOMED

  • 237662005 hyperprolactinemia (disorder)

  • 237668009 Pregnancy hyperprolactinemia (disorder)

  • 23766...

CLINICAL PEARLS

  • If a cause for hyperprolactinemia cannot be found by history, examination, and routine laboratory testing, an intracranial lesion might be the cause and brain MRI with specific pituita...

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