title: Approach to the patient with persistent hyperprolactinemia and negative sellar imaging.
abstract: Hyperprolactinemia is a common cause of menstrual disturbances affecting young women. There is a diversity of causes, from physiological, such as pregnancy, to pharmacological and pathological, such as hypothyroidism. Renal and hepatic failure, intercostal nerve stimulation by trauma or surgery, prolactinomas, other tumors in the hypothalamus-pituitary region, as well as macroprolactinemia can also be considered. Identifying the correct cause is important to establish the correct treatment. Should all these causes be ruled out and pituitary imaging revealed as negative, idiopathic hyperprolactinemia is therefore diagnosed. In symptomatic patients, treatment with dopaminergic agonists is indicated. As for the asymptomatic hyperprolactinemic individuals, macroprolactinemia should be screened, and once it is detected, there is no need for pituitary imaging study or for dopaminergic agonist use.
authors: Unidade de Neuroendocrinologia, Disciplina de Endocrinologia e Metabologia, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, SP, Brazil.
authors: Andrea
authors: A
authors: Glezer
authors: Marcello D
authors: MD
authors: Bronstein
mesh_terms: D000328:Adult; D003937:Diagnosis, Differential; D018491:Dopamine Agonists / Q000627:therapeutic use; D005260:Female; D006801:Humans; D006966:Hyperprolactinemia / Q000000981:diagnostic imaging* / Q000188:drug therapy / Q000209:etiology* / Q000628:therapy*; D007247:Infertility, Female / Q000150:complications / Q000175:diagnosis / Q000209:etiology; D008279:Magnetic Resonance Imaging; D011388:Prolactin / Q000097:blood; D011859:Radiography; D012008:Recurrence; D012658:Sella Turcica / Q000000981:diagnostic imaging* / Q000473:pathology
chemical_list: D018491:Dopamine Agonists; D011388:Prolactin