title: [Current diagnosis and treatment of hyperprolactinemia].
abstract: Hyperprolactinemia is a frequent neuroendocrinological condition that should be approached in an orderly and integral fashion, starting with a complete clinical history. Once physiological causes such as pregnancy, systemic disorders such as primary hypothyroidism and the use of drugs with dopamine antagonistic actions such as metochlopramide have been ruled out, the most common cause of hyperprolactinemia is a PRL-secreting pituitary adenoma or prolactinoma. Prolactinomas are usually classified as microprolactinomas (less than 1 cm) or macroprolactinomas (larger than 1 cm), which can either be confined or invasive. The hormonal consequence of hypeprolactinemia is hypogonadism; in women, this is manifested as amenorrhea/oligomenorreha, anovulation and galactorrhea, whereas in men the main complaints are a diminished libido and erectile dysfunction. Macroprolactinomas can also present with symptoms and signs resulting form mass effect of the tumor, such as headaches and visual field defects. Other structural causes of hyperprolactinemia include non-functioning pituitary adenomas and infiltrative disorders, which can interrupt the inhibitory, descending dopaminergic tone. The primary treatment of prolactinomas is pharmacological with dopamine agonists such as cabergoline.
authors.affiliation: Centro Neurológico, Centro Médico ABC, Distrito Federal, México. mmercadoa@yahoo.com.
authors.forename: Virgilio
authors.initials: V
authors.lastname: Melgar
authors.forename: Etual
authors.initials: E
authors.lastname: Espinosa
authors.forename: Ernesto
authors.initials: E
authors.lastname: Sosa
authors.forename: María José
authors.initials: MJ
authors.lastname: Rangel
authors.forename: Dalia
authors.initials: D
authors.lastname: Cuenca
authors.forename: Claudia
authors.initials: C
authors.lastname: Ramírez
authors.forename: Moisés
authors.initials: M
authors.lastname: Mercado
mesh_terms: D000236:Adenoma / Q000150:complications / Q000175:diagnosis; D000077465:Cabergoline; D018491:Dopamine Agonists / Q000627:therapeutic use; D004873:Ergolines / Q000627:therapeutic use; D006801:Humans; D006966:Hyperprolactinemia / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology / Q000503:physiopathology; D010911:Pituitary Neoplasms / Q000150:complications / Q000175:diagnosis; D015175:Prolactinoma / Q000150:complications / Q000175:diagnosis
chemical_list: D018491:Dopamine Agonists; D004873:Ergolines; D000077465:Cabergoline
keywords: Dopamine agonists; Ergolines; Hyperprolactinemia; Prolactin; Prolactinoma