Hyperprolactinemia

Prolactin ( PRL ) is a polypeptide hormone-containing 198 amino acids and with a molecular weight of 22kDa. Hyperprolactinemia is elevated serum PRL.Women → 500 milliunits/ L or < 25 micrograms /LMen → 400 milliunits / L or 20 micrograms / LProlactin levels of over 3000 mII/L suggest the presence of a Prolactinoma.

PRL is synthesized and secreted by lactotroph cells in the anterior pituitary Also secreted by various extra pituitary tissues including several brain regions, lymphocytes, mammary epithelial cells, tumours, decidua, myometrium, lacrimal glands, thymus and the spleen Secretion is pulsatile → levels fluctuate throughout the day and the menstrual cycle Unique hormone - predominantly negative mode of regulation by the hypothalamus○ no hypothalamus derived releasing hormone○ controlled by the inhibitory effect of DOPAMINE released from the hypothalamus Acts to induce and maintain lactation of the primed breast ( Mammogenic & lactogenic ) Nonpeurperal hyperprolactinemia is caused by lactotroph adenomas → PROLACTINOMA. Prolactinomas account for 40 % of all pituitary tumours

Causes- physiological Coitus Exercise Lactation Pregnancy Sleep Stress. Pathological- Granulomas Infiltration Irradiation Rathke's cyst Trauma○ pituitary stalk section○ suprasellar surgery Tumours○ craniopharyngioma○ germinoma○ hypothalamic metasteses○ meningioma○ suprasellar pituitary mass Acromegaly Idiopathic Lymphocytic hypophysitis of parasellar mass Macroadenoma Macroprolactinemia...