title: Tumoral versus non-tumoral hyperprolactinemia in children and adolescents: possible usefulness of the domperidone test.
abstract: The aim of this study was to evaluate the usefulness of the domperidone test for the difficult diagnosis between functional and tumoral hyperprolactinemia. We evaluated 36 patients, aged 5-18 years, 14 (12 F, 2 M) with hyperprolactinemia (non-tumoral: 10; pituitary adenoma: 4) and 22 individuals as a control group (prepubertal: 5 F, 8 M; pubertal: 4 F, 5 M). Basal prolactin (PRL) (IRMA-DPC), T4 and TSH and PRL 30 min post-domperidone (0.2 mg/kg b. wt i.v.) were measured. Non-tumoral hyperprolactinemic females showed basal PRL: 45 (29-80) (median and range) ng/ml; post-domperidone: 208 (116-290) ng/ml; delta PRL (PRL 30' - PRL 0'): 167 (77-252) ng/ml; and PRL ratio (PRL 30'/PRL 0'): 3.9 (2.3-7.6). Females with pituitary adenoma showed basal PRL: 129 (125-660) ng/ml; post-domperidone: 202 (150-535) ng/ml; delta PRL: 73 (25-135) ng/ml; and ratio: 1.2 (0.8-1.6). Two males, one with a non-tumoral hyperprolactinemia and the other one with a pituitary adenoma, presented, respectively, PRL 0':45, 160; PRL 30':130, 173; delta: 85, 13; ratio: 2.9, 1.1. All non-tumoral patients showed a PRL ratio (30'/0') > 2.3, while no patient with pituitary adenoma had a ratio > 1.6.
  
  
  CONCLUSIONS
  PRL response to domperidone allowed us to characterize hyperprolactinemias, although the presence of a blunted response should be confirmed in a larger number of patients with tumors with 'low' PRL levels (dependence on etiology or basal PRL level?).
authors.affiliation: Endocrinology Unit, Medicine Department, Hospital T. Alvarez, Buenos Aires, Argentina. hugofideleff@arnet.com.ar
authors.forename: Hugo L
authors.initials: HL
authors.lastname: Fideleff
authors.forename: Miriam
authors.initials: M
authors.lastname: Azaretzky
authors.forename: Hugo R
authors.initials: HR
authors.lastname: Boquete
authors.forename: Andrea B
authors.initials: AB
authors.lastname: Pujol
authors.forename: Margarita
authors.initials: M
authors.lastname: Honfi
authors.forename: Martha G
authors.initials: MG
authors.lastname: Suárez
authors.forename: Gabriel
authors.initials: G
authors.lastname: Fideleff
authors.forename: Ana V
authors.initials: AV
authors.lastname: Giaccio
mesh_terms: D000236:Adenoma / Q000150:complications* / Q000000981:diagnostic imaging; D000293:Adolescent; D002648:Child; D004294:Domperidone; D018492:Dopamine Antagonists; D005260:Female; D006801:Humans; D006966:Hyperprolactinemia / Q000175:diagnosis* / Q000209:etiology*; D008279:Magnetic Resonance Imaging; D008297:Male; D010911:Pituitary Neoplasms / Q000150:complications* / Q000000981:diagnostic imaging; D011388:Prolactin / Q000097:blood; D011859:Radiography; D011863:Radioimmunoassay; D012727:Sex Characteristics
chemical_list: D018492:Dopamine Antagonists; D004294:Domperidone; D011388:Prolactin