Anita Blythe is a 24 year-old woman with a 4-month history of amenorrhea and galactorrhea.
List 5 reasons why her prolactin may be elevated.
- Physiologic:
- pregnancy
- breast feeding
- nipple stimulation
- Drug induced:
- Dopamine antagonist
- domperidone
- Endocrine:
- Primary hypothyroidism
- Addison’s disease
- Decreased clearance:
- renal failure
- hepatic failure
- Central:
- prolactinoma
- stalk-effect from pituitary macroadenoma
- Macroprolactin (unlikely, since symptomatic)
What is the primary therapy for a symptomatic prolactinoma?
Dopamine agonists: cabergoline, bromocriptine, or quinagolide.
