Chapter 169 Hyperprolactinemia
INTRODUCTION
Description: Hyperprolactinemia is the pathologic elevation of serum prolactin levels. The finding of elevated levels of prolactin is nonspecific as to cause, requiring careful clinical evaluation.
ETIOLOGY AND PATHOGENESIS
Causes: Pituitary adenoma (most common), pharmacologic (most often those that affect dopamine or serotonin: major tranquilizers [phenothiazines], trifluoperazine [Stelazine], and haloperidol [Haldol]; some antipsychotic medications; metoclopramide [Reglan], less often, α-methyldopa and reserpine), herpes zoster, chest wall/breast stimulation or irritation, physiologic during pregnancy, or after childbirth and/or breastfeeding.
DIAGNOSTIC APPROACH
Workup and Evaluation
Imaging: Computed tomography (CT) or magnetic resonance imaging (MRI) to evaluate the pituitary and surrounding bony structures; magnetic resonance imaging now is preferred.
