Hyperprolactinemia
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Hyperprolactinemia
Pathology
Adrenal gland disorders
Congenital adrenal hyperplasia
Primary adrenal insufficiency
Waterhouse-Friderichsen syndrome
Hyperaldosteronism
Adrenal cortical carcinoma
Cushing syndrome
Conn syndrome
Thyroid gland disorders
Thyroglossal duct cyst
Hyperthyroidism
Graves disease
Thyroid eye disease (NORD)
Toxic multinodular goiter
Thyroid storm
Hypothyroidism
Euthyroid sick syndrome
Hashimoto thyroiditis
Subacute granulomatous thyroiditis
Riedel thyroiditis
Postpartum thyroiditis
Thyroid cancer
Parathyroid gland disorders
Hyperparathyroidism
Hypoparathyroidism
Hypercalcemia
Hypocalcemia
Pancreatic disorders
Diabetes mellitus
Diabetic retinopathy
Diabetic nephropathy
Pituitary gland disorders
Hyperpituitarism
Pituitary adenoma
Hyperprolactinemia
Prolactinoma
Gigantism
Acromegaly
Hypopituitarism
Growth hormone deficiency
Pituitary apoplexy
Sheehan syndrome
Hypoprolactinemia
Constitutional growth delay
Diabetes insipidus
Syndrome of inappropriate antidiuretic hormone secretion (SIADH)
Gonadal dysfunction
Precocious puberty
Delayed puberty
Premature ovarian failure
Polycystic ovary syndrome
Androgen insensitivity syndrome
Kallmann syndrome
5-alpha-reductase deficiency
Polyglandular syndromes
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Endocrine tumors
Multiple endocrine neoplasia
Pancreatic neuroendocrine neoplasms
Zollinger-Ellison syndrome
Carcinoid syndrome
Pheochromocytoma
Neuroblastoma
Opsoclonus myoclonus syndrome (NORD)
Endocrine system pathology review
Adrenal insufficiency: Pathology review
Adrenal masses: Pathology review
Hyperthyroidism: Pathology review
Hypothyroidism: Pathology review
Thyroid nodules and thyroid cancer: Pathology review
Parathyroid disorders and calcium imbalance: Pathology review
Diabetes mellitus: Pathology review
Cushing syndrome and Cushing disease: Pathology review
Pituitary tumors: Pathology review
Hypopituitarism: Pathology review
Diabetes insipidus and SIADH: Pathology review
Multiple endocrine neoplasia: Pathology review
Neuroendocrine tumors of the gastrointestinal system: Pathology review
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Hyperprolactinemia p. 250, 334, 544
anovulation p. 669
calcium channel blockers and p. 325
risperidone and p. 597
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Content Reviewers
Rishi Desai, MD, MPHContributors
Brittany Norton, MFA
Jahnavi Narayanan, MBBS
Jake Ryan
Robyn Hughes, MScBMC
With hyperprolactinemia, hyper- means above, -prolactin refers to the hormone produced by the pituitary gland, and -emia refers to the blood, so hyperprolactinemia means higher than normal prolactin levels in the blood.
Normally, at the base of the brain, there’s a small pea-sized gland called the pituitary gland.
The anterior pituitary - the front of the pituitary gland - has a number of different cells, each of which secretes a different hormone.
One group, the lactotroph cells, secrete prolactin. In men, excess prolactin decreases testosterone production.
In women, during pregnancy, elevated levels of estrogen stimulate the lactotrophs to produce large amounts of prolactin which stimulates alveolar cells in the breasts.
In response to prolactin, the alveolar cells divide and enlarge - and once a baby is born, lactogenesis begins - which means that milk is produced.
Apart from milk production, high levels of prolactin also inhibit the release of gonadotropin releasing hormone from the hypothalamus, which results in decreased luteinizing and follicle stimulating hormone levels, which in turn, decreases estrogen levels.
In women, this can stop ovulation and menstruation, which is why women typically don’t have a menstrual period while breastfeeding. In women that are not pregnant or breastfeeding, and in men, prolactin levels are usually kept in check by the hypothalamus in two ways.
Sources
- "Robbins Basic Pathology" Elsevier (2017)
- "Harrison's Principles of Internal Medicine, Twentieth Edition (Vol.1 & Vol.2)" McGraw-Hill Education / Medical (2018)
- "Pathophysiology of Disease: An Introduction to Clinical Medicine 8E" McGraw-Hill Education / Medical (2018)
- "Harrison's Endocrinology, 4E" McGraw-Hill Education / Medical (2016)
- "Laboratory and clinical significance of macroprolactinemia in women with hyperprolactinemia" Taiwanese Journal of Obstetrics and Gynecology (2017)
- "Pitfalls in the Diagnostic Evaluation of Hyperprolactinemia" Neuroendocrinology (2019)
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