title: Systemic lupus erythematosus with a non functioning pituitary macroadenoma.
abstract: BACKGROUND
  Malignancies are more common in patients with systemic lupus erythematosus (SLE) than the general population. SLE patients are recognized to have higher prolactin levels. However, there are very few reported cases of SLE with pituitary adenomas.
  
  
  METHODS
  We report the second case of a pituitary adenoma in a patient with underlying SLE. A 51 year old lady presented with blurred vision and magnetic resonance imaging of the brain demonstrated a pituitary macroadenoma with mildly elevated serum prolactin levels. The diagnosis of a non functioning pituitary macroadenoma was confirmed histologically. The diagnosis of SLE was made on the basis of thrombocytopenia, antinuclear antibodies, anti double stranded DNA antibodies and lupus nephritis (confirmed on renal biopsy). The patient initially received medical therapy with carbegoline, followed by transsphenoidal neurosurgery for the pituitary macroadenoma. SLE with lupus nephritis was treated with steroids and low dose intravenous cyclophosphamide.
  
  
  CONCLUSIONS
  Hyperprolactinaemia is prevalent in twenty to thirty percent of SLE patients but it is rarely due to a prolactinoma. The source of excessive circulating prolactin in SLE patients has not been fully determined.
authors.affiliation: Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia.
authors.forename: Ummi
authors.initials: U
authors.lastname: Nadira
authors.forename: Rizna Abdul
authors.initials: RA
authors.lastname: Cader
authors.forename: Norella C T
authors.initials: NC
authors.lastname: Kong
authors.forename: Rozita
authors.initials: R
authors.lastname: Mohd
authors.forename: Halim A
authors.initials: HA
authors.lastname: Gafor
keywords: pituitary macroadenoma; prolactin; systemic lupus erythematosus