[Hyperprolactinemia: causes, diagnosis, and treatment].
The basic data on hyperprolactinemia (i.e. an excess of PRL above a reference laboratory's upper limits), the most common endocrine disorder of the hypothalamic-pituitary axis are given in this review. The following issues are discussed: regulation of prolactin (Prl) secretion, definition of hyperprolactinemia, its etiology and pathogenesis as well as its symptoms, diagnosis, and treatment (including medical and surgical therapy). It should be stressed that finding of elevated PRL serum concentrations constitute the beginning of diagnostic procedure and, after exclusion of physiologic, pharmacologic, and other organic causes of increased PRL levels, should be followed by detailed diagnosis including MRI. In patients in whom hyperprolactinemia has been confirmed the treatment with dopamine agonists (with prevalence of cabergoline, followed by quinagoline) is currently considered first-choice therapy. Surgery should be performed only in the patients resistant or intolerant to these agents, or in patients who refuse long-term therapy.
Karasek
Michał
M
Department of Neuroendocrinology, Chair of Endocrinology, Medical University, Lodz. karasek@csk.umed.lodz.pl
Pawlikowski
Marek
M
Lewiński
Andrzej
A
D000634:Aminoquinolines / Q000627:therapeutic use; D000818:Animals; D000077465:Cabergoline; D018491:Dopamine Agonists / Q000627:therapeutic use; D004873:Ergolines / Q000627:therapeutic use; D006801:Humans; D006966:Hyperprolactinemia / Q000175:diagnosis / Q000209:etiology / Q000628:therapy; D007030:Hypothalamo-Hypophyseal System / Q000000981:diagnostic imaging / Q000503:physiopathology*; D011388:Prolactin / Q000097:blood* / Q000187:drug effects / Q000378:metabolism; D011859:Radiography; D016896:Treatment Outcome
D000634:Aminoquinolines; D018491:Dopamine Agonists; D004873:Ergolines; C046650:quinagolide; D011388:Prolactin; D000077465:Cabergoline