Background: Hyperprolactinemia can be physiological or due to a pharmacological/pathological cause. It is relatively rare in childhood and poorly described in the literature.
Objective and hypotheses: The aim of this study was to retrospectively evaluate the etiology, clinical findings and management of hyperprolactinemia in children.
Method: We reviewed the records of 91 children with hyperprolactinemia (Prolactin level >760 mU/L) presenting to the Childrens Hospital at Westmead between 2009 and 2014. Data collected included; age, gender, anthropometric data, symptoms, pubertal status, pituitary hormone profile, prolactin level, MRI brain and management details.
Results: The mean age of presentation was 11.7±5.01 years with equal sex distribution. Hyperprolactinemia was secondary to pharmacological agents in 30, prolactin secreting pituitary adenoma in four, hypothalamic-pituitary dysfunction in 12, hypothyroidism in two, macroprolactin in two, physiological causes in 24 and idiopathic in 16 patients. Risperidone was the commonest drug responsible for the hyperprolactinemia (n=19). The majority of patients (84%) were asymptomatic. The mean prolactin level was 1700±2471 mU/L (761 to 20,288 mU/L) for the whole group, 1452±806 mU/L (761 to 3922 mU/L) for drug induced hyperprolactinemia and 7968±3507 mU/L (1660 to 20,288 mU/L) in patients with pituitary adenoma. MRI brain reports were available for 46 patients out of which 30 patients had abnormal findings; 16 with abnormality responsible for hyperprolactinemia and 14 with abnormality thought to be unrelated to hyperprolactinemia. Of the four patients with a pituitary adenoma, two patients were treated with surgery and two with dopamine agonists.
Conclusion: Hyperprolactinemia presents mainly in late childhood and patients are often asymptomatic. Drug induced hyperprolactinemia was the commonest cause of hyperprolactinemia in children presenting to our tertiary service. Children with hyperprolactinemia should be investigated further if they are symptomatic or prolactin levels >1500 mU/L.
10 - 12 Sep 2016
European Society for Paediatric Endocrinology