Longstanding hyperprolactinemia associated with systemic lupus erythematosus: possible hormonal stimulation of an autoimmune disease.
OBJECTIVE
To describe 4 women in whom hyperprolactinemia was associated with the development of systemic lupus erythematosus (SLE).


METHODS
Clinical assessment and followup (2 cases). Chart review and interviews with the attending rheumatologist (2 cases). Detailed review and reassessment of multiple imaging studies of the pituitary.


RESULTS
One patient had idiopathic hyperprolactinemia, and 3 had pituitary microadenomas. Serum 17 beta-estradiol concentrations were normal in all women, but serum testosterone was suppressed in 2. SLE flares occurred in 2 individuals, one and 6 months after bromocriptine therapy was discontinued, and reinstitution of bromocriptine therapy in a patient who refused corticosteroids resulted in resolution of her SLE disease activity.


CONCLUSIONS
Hyperprolactinemia, which has the potential to exacerbate autoimmunity, may coexist with SLE. In these instances, bromocriptine may afford therapeutic benefit.
McMurray
R W
RW
Division of Immunology and Rheumatology, University of Missouri-Columbia 65212.
Allen
S H
SH
Braun
A L
AL
Rodriguez
F
F
Walker
S E
SE
D000328:Adult; D001327:Autoimmune Diseases / Q000150:complications* / Q000188:drug therapy; D001971:Bromocriptine / Q000627:therapeutic use; D005260:Female; D006801:Humans; D006966:Hyperprolactinemia / Q000150:complications* / Q000188:drug therapy; D008180:Lupus Erythematosus, Systemic / Q000150:complications*; D010911:Pituitary Neoplasms / Q000150:complications / Q000000981:diagnostic imaging; D015175:Prolactinoma / Q000150:complications / Q000000981:diagnostic imaging; D011859:Radiography; D013997:Time Factors
D001971:Bromocriptine