Internal Medicine

0521779407-17 CUNY1086/Karliner 0 521 77940 7 June 4, 2007 21:19

Prion Disorders Prolactinoma and Galactorrhea 1219

management

■Supportive

specific therapy

■None available

follow-up

n/a

complications and prognosis

■Relentlessly progressive, although transient improvement may occur

■In most sporadic cases, death occurs within 1 year

■In familial forms, disease duration depends on specific mutation

PROLACTINOMA AND GALACTORRHEA

ANDREW R. HOFFMAN, MD

history & physical

History

■Infertility, amenorrhea or oligoamenorrhea, pregnancy, breast feed-

ing

■Impotence

■Psychotropic drug use

■Hypothyroidism

■Renal failure

■Family history of pituitary tumor

■Persistence of galactorrhea after cessation of breast feeding

Signs & Symptoms

■Galactorrhea (rare in men)

■Headache

■Decreased libido

■Visual field defect

■Osteoporosis

■Hypopituitarism

■Occasionally occurs in acromegaly

tests

Laboratory

■Basic blood studies:

➣Prolactin, free T4, TSH, IGF-I, GH

➣Serum pregnancy test (beta-hCG)