Prolactin response to thyrotropin-releasing hormone (TRH) in patients with hypothalamic-pituitary disease.
The prolactin (PRL) response to thyrotropin-releasing hormone (TRH) was evaluated in 686 patients over a 4-year period. Of the 170 control subjects tested, none had a blunted PRL response to TRH. Eighty patients with prolactinomas documented by surgery were tested. Ninety-five percent (76 of 80) of these patients had an abnormally blunted PRL response to TRH. Of the 87 patients with a prolactinoma who did not undergo surgery, 98% (85 of 87) had a blunted PRL response to TRH. Many patients with other pituitary and hypothalamic diseases (pituitary tumors other than prolactinomas [Cushing's disease, acromegaly, chromophobe adenoma], craniopharyngioma) also had an abnormal PRL response to TRH (79 of 153, 52%). In the majority of patients with hyperprolactinemia due to dopamine antagonist medications, TRH stimulation did not produce a normal rise in PRL. The TRH test may be helpful in confirming the diagnosis of prolactinoma, but it is not a decisive factor in the diagnosis or management of this entity.
D000236:Adenoma / Q000378:metabolism; D003937:Diagnosis, Differential; D018492:Dopamine Antagonists; D005069:Evaluation Studies as Topic; D005260:Female; D006801:Humans; D007027:Hypothalamic Diseases / Q000175:diagnosis* / Q000378:metabolism; D008297:Male; D010900:Pituitary Diseases / Q000175:diagnosis* / Q000378:metabolism; D010901:Pituitary Function Tests / Q000379:methods; D010911:Pituitary Neoplasms / Q000378:metabolism; D011388:Prolactin / Q000097:blood* / Q000378:metabolism; D012737:Sex Factors; D013959:Thyroid Diseases / Q000378:metabolism; D013973:Thyrotropin-Releasing Hormone
D018492:Dopamine Antagonists; D013973:Thyrotropin-Releasing Hormone; D011388:Prolactin