Aim: In this study, we planned to evaluate the patients with hyperprolactinemia etiology, clinical features and treatment responses.
Material and Method: We evaluated retrospectively the features, clinical follow-up data and treatment responses of the patients with hyperprolactinemia in our pediatric endocrinology clinic between 01.01.2012-31.12.2018.
Results: Thirty-one patients with hyperprolactinemia underwent follow-up in a seven-year period. The mean age of these cases was 15.7±1.5years. 27 cases (87.1%) were female. The most common complaints in girls were menstrual irregularity / amenorrhea (n = 14) and galactorrhea (n = 8). In terms of etiology, microadenomas were observed in 9, macroadenomas in 4, idiopathic hyperprolactinemia in 12, and drug-induced hyperprolactinemia in 4 cases. The mean prolactin level in the whole group was 104.7 ± 145.4 (27.8-813) ng/ml. According to the etiology, the mean prolactin level was 43,6 ng/ml in drug-induced hyperprolactinemia, 137,8 ng/ml in microadenomas group, 285 ng / ml in macroadenomas group, idiopathic hyperprolactinemia group was 49.6 ng/ml. All cases with a prolactin level above 100 ng/ml were diagnosed as adenoma(3 macroadenomas and 5 microadenomas). Medical treatment was performed in 24 patients (23 cases with cabergoline, 1 case with bromocriptine) and surgery was performed in 3 cases (1 patient with Rathke cleft cyst, 2 cases with macroadenomas). Seven patients were followed without treatment. Cabergoline dose was 0.52 ± 0.21 (0.25-1) mg/week, and the mean time to normalization of prolactin levels was 2.6 ± 3 (1-12) months. There were no side effects related to cabergoline. Postoperative prolactin levels did not return to normal in 2 patients with hyperprolactinemia due to macroadenomas and Rathke cleft cyst, and the need for medical treatment continued. Multiple pituitary hormone deficiencies (gonadotropin, TSH, ACTH) was diagnosed in one patient with macroadenomas. The patient's cabergoline treatment (1 mg/week) and prolactin levels returned to normal in the first month. At the eighth month, the adenomas shrank almost completely.
Conclusion: The cases diagnosed as hyperprolactinemia were mostly adolescent girls. The most common cause was the pituitary adenomas (42%) and 64% of these adenomas were microadenomas. In patients with hyperprolactinemia, a good response to medical treatment including those due to adenoma, and a small number of cases required surgical treatment.
Keywords: hyperprolactinemia, prolactinomas, cabergoline, surgery
19 Sep 2019 - 21 Sep 2019