SPECTRUM OF DISORDERS LEADING TO HYPERPROLACTINEMIA
Objective: To determine the frequency of disorders leading to hyperprolactinemia (HP) in patients who reported to AFIP Rawalpindi.
Study Design: Cross- sectional study.
Place and duration of study: Department of Chemical Pathology and Endocrinology, Armed Forces Institute of Pathology Rawalpindi, from January to June 2011.
Patients and Methods: Patients with serum prolactin levels > 530 ml U/l in females and 360 ml U/l in males were included. Patients with hyperprolactinemia(HP) due to physiological causes (pregnancy and lactation etc), drug induced, irradiation and hypothyroid patients on thyroxin treatment were excluded. Seventy six samples were collected from the patients for the workup of pathological conditions. Serum prolactin, FSH, LH, estradiol, testosterone, GH, cortisol, TSH and free T4 were analysed on Immulite 2000, while LFTs and RFTs on Hitachi. Pituitary adenomas were confirmed by MRI.
Results: Seventy six patients had HP due to pathological causes, 13(17%) males and 63(83%) females had mean age of 30±11 years. Pituitary microadenoma was the cause of hyperprolactinemia in 30 (39.5%) cases, pituitary macroadenoma in 12 (15.8%), subclinical hypothyroidism in 14 (18.4%), primary hypothyroidism in 10 (13.2%), PCOS in 4 (5.3%), cirrhosis in 2 (2.6%), idiopathic in 2 (2.6%), CKD in 1 (1.3%) and acromegaly in 1 (1.3%) patient. HP was significantly correlated with size of prolactinoma and serum TSH levels (primary and subclinical hypothyroidism)(p value < 0.05).
Conclusion: It is concluded that prolactinoma is the commonest pathology causing hyperprolactinemia, followed by hypothyroidism and PCOS in patients who reported to AFIP Rawalpindi. This will help in early diagnosis along with further management of the patient.