ESPE Abstracts

Background/Purpose: Hyperprolactinemia is a rare endocrine disorder in childhood and there are limited etiological, clinical, and demographic data. The purpose of this study was to evaluate the clinical features and course of hyperprolactinemia in childhood and adolescents and to help diagnose and plan the management.

Methods: In this single-center retrospective study included 21 patients with hyperprolactinemia from Ajou University Division of Pediatric Endocrinology. Clinical symptoms, brain magnetic resonance imaging (MRI), serum prolactin (PRL) levels, associated diseases, medications, and post-treatment course were reviewed.

Results: Among 21 patients (male=10, female=11) with hyperprolactinemia, 5 females were diagnosed with prolactinomas (median age 16.1 years, range 15.2–17.0 years). 16 patients were diagnosed with idiopathic hyperprolactinemia (median age 10.9 years, range 6.3-16.2 years, 6 females, 10 males). The mean PRL level at diagnosis was higher in patients with prolactinoma (134.12±112.05 ng/mL) than in patients with idiopathic hyperprolactinemia (27.48±9.13 ng/mL) (P=0.008) Children with hyperprolactinemia presented variable clinical symptoms. The clinical manifestations of hyperprolactinemia at diagnosis were headache (7/11, 63.6%), menstrual irregularities (5/11, 45.5%), galactorrhea (3/11, 27.3%), visual field defect (1/11, 9.1%), obesity (1/11, 9.1%) in girls. In boys, gynecomastia (8/10, 80%) and obesity (6/10, 60%) were present. Headache and menstrual irregularities were more common in patients diagnosed with prolactinoma than in patients with idiopathic hyperprolactinemia. Cabergoline as medical treatment (n=2) decreased the tumor volume and normalized the PRL level.

Conclusion: In children and adolescents with irregular menstrual cycles and headache, hyperprolactinemia is suspected prolactinoma and cabergoline was effective for the treatment of prolactinoma.