Hyperprolactinaemia

Hyperprolactinemia, Prolactinoma: Examination

A comprehensive clinical examination is the basis for selecting further diagnostic steps: General physical examination–including blood pressure, pulse, body weight, height; further: Inspection (viewing). Skin and mucous membranes Abdomen (abdomen) Shape of the abdomen? Skin color? Skin texture? Efflorescences (skin changes)? Pulsations? Bowel movements? Visible vessels? Scars? Hernias (fractures)? Inspection and palpation (palpation) of the … Hyperprolactinemia, Prolactinoma: Examination

Hyperprolactinemia, Prolactinoma: Test and Diagnosis

1st order laboratory parameters-obligatory laboratory tests. Hormone diagnostics Stage I: Basal prolactin (in fasting state; for detailed information on prolactin, see laboratory diagnostics) – this should be determined several times! Thyroid-stimulating hormone (TSH). Stage II: Prolactin (PRL) after TRH administration – used to determine the functional reserve of the prolactin-producing cells of the pituitary gland … Hyperprolactinemia, Prolactinoma: Test and Diagnosis

Hyperprolactinemia, Prolactinoma: Drug Therapy

Therapy for hyperprolactinemia depends on the causes, the level of serum prolactin, and, in the case of existing prolactinomas (see surgical therapy for details), their extent. Therapy goals Improvement of the symptomatology Regression of the prolactinoma Therapy recommendations Hyperprolactinemia in reproductive age in the absence of a current desire to have children. Prolactin inhibitors (dopamine … Hyperprolactinemia, Prolactinoma: Drug Therapy

Hyperprolactinemia, Prolactinoma: Diagnostic Tests

Obligatory medical device diagnostics. Magnetic resonance imaging of the skull (cranial MRI or cMRI): thin-slice images of the sella turcica in coronal and sagittal slice directions in T2 and T1 weighting with and without contrast medium. MRI can be used to visualize even the smallest changes in the pituitary gland (e.g., mircoadenomas) CT is now … Hyperprolactinemia, Prolactinoma: Diagnostic Tests

Hyperprolactinemia, Prolactinoma: Surgical Therapy

Surgical removal of prolactinoma is indicated only when drug therapy fails or there is intolerance to the agents. Drug therapy should also be initiated primarily if vision is impaired. If this does not bring a rapid improvement, surgery is indicated. The procedure of choice is then transsphenoidal pituitary surgery* or transfrontal pituitary surgery; transnasal surgery … Hyperprolactinemia, Prolactinoma: Surgical Therapy

Hyperprolactinemia, Prolactinoma: Symptoms, Complaints, Signs

A microadenoma (tumor size: < 1 cm) is often clinically asymptomatic and occasionally presents with symptoms of hyperprolactinemia. The following symptoms and complaints may indicate hyperprolactinemia: Symptoms in women Galactorrhea (abnormal breast milk discharge; seen in approximately 25-40% of women with hyperprolactinemia). Secondary hypogonadism/gonadal hypofunction (estrogen deficiency). Arrhythmias Amenorrhea – no menstrual bleeding until age … Hyperprolactinemia, Prolactinoma: Symptoms, Complaints, Signs

Hyperprolactinemia, Prolactinoma: Causes

Hyperprolactinemia Pathogenesis (disease development) Prolactin (PRL, synonyms: lactotropic hormone (LTH); lactotropin) is a hormone from the anterior pituitary (HVL) that acts on the mammary gland and controls milk production in women after pregnancy.Prolactin itself is inhibited by prolactin inhibiting factor (PIF), which is produced in the hypothalamus (section of the diencephalon near the optic nerve … Hyperprolactinemia, Prolactinoma: Causes

Hyperprolactinemia, Prolactinoma: Complications

The following are the most important diseases or complications that may be contributed to by hyperprolactinemia: Musculoskeletal system and connective tissue (M00-M99). Osteoporosis (bone loss) Neoplasms – tumor diseases (C00-D48) Recurrence of hyperprolactinemia Genitourinary system (kidneys, urinary tract – reproductive organs) (N00-N99). Gynecomastia – enlargement of the mammary gland in men. Loss of libido (man) … Hyperprolactinemia, Prolactinoma: Complications

Hyperprolactinemia, Prolactinoma: Classification

Urinary bladder carcinoma is classified as follows: TNM classification for staging T: depth of infiltration of the tumor. Tis: carcinoma in situ Ta: noninvasive papillary tumor T1: infiltration to lamina submucosa T2a/b: Infiltration Infiltration of urinary bladder muscles (a: superficial/b: deep). T3 a/b: Infiltration of perivesical structures (a: microscopic/b: macroscopic). T4 a/b: Infiltration of adjacent … Hyperprolactinemia, Prolactinoma: Classification

Hyperprolactinemia, Prolactinoma: Medical History

Medical history (history of illness) represents an important component in the diagnosis of prolactinoma. Family history Social history Is there any evidence of psychosocial stress or based on your family situation? Current medical history/systemic history (somatic and psychological complaints). Women What symptoms have you noticed? When was your last menstrual period? At what intervals does … Hyperprolactinemia, Prolactinoma: Medical History

Hyperprolactinemia, Prolactinoma: Or something else? Differential Diagnosis

Endocrine, nutritional, and metabolic diseases (E00-E90). Acromegaly – endocrinologic disorder caused by overproduction of growth hormone (somatotropic hormone (STH), somatotropin), with marked enlargement of the phalanges or acras, such as the hands, feet, mandible, chin, nose, and eyebrow ridges. Primary hypothyroidism (primary hypothyroidism) – primary hypothyroidism is commonly referred to when the thyroid gland itself … Hyperprolactinemia, Prolactinoma: Or something else? Differential Diagnosis

Hyperprolactinemia, Prolactinoma: Therapy

General measures Review of permanent medication due topossible effect on existing disease. Avoidance of psychosocial stress: Stress Radiotherapy Radiation therapy for prolactinoma is indicated only in exceptional cases when there is no improvement with drug therapy as well as surgical therapy. Regular check-ups Regular medical checkups Psychotherapy Stress management, if necessary Detailed information on psychosomatics … Hyperprolactinemia, Prolactinoma: Therapy