589
Disorders of Prolactin
Secretion
Chapter 59
Stephanie J. Estes, MD, FACOG
❍ What are the pituitary causes of hyperprolactinemia?
Pituitary disease (most common 50%).
- Prolactinomas
- Lymphocytic hypophysitis
- Empty sella syndrome
- Cushing disease
- Growth hormone-secreting tumors
- Plurihormonal adenoma
❍ What are other causes of hyperprolactinemia?
Hypothalamic disease (rare)
- Craniopharyngiomas, meningiomas, metastasis of other tumors
- Vascular
- Pituitary stalk section
- Suprasellar surgery or mass extension
- Irradiation
Granulomas, infiltrations
Neurologic - Chest wall lesions (chest trauma, herpes zoster; with neural mechanism similar to suckling)
- Spinal cord lesions
- Breast stimulation
- Epileptic seizures
Medications - Phenothiazines
- Tricyclic antidepressants, SSRI’s
- Narcotics
- Centrally acting antihypertensive agents (methyldopa, reserpine)
- Verapamil (unknown mechanism; does not occur with other Ca channel blockers)
- Oral contraceptive pills
- Antiemetics (metoclopramide)