Fifty nine patients with inappropriate lactation and secondary amenorrhea were studied. There was no apparent cause of the amenorrhea galactorrhea in 51 women, and pituitary tumor was diagnosed in 8 cases. All patients had normal adrenal function, and hypothyroidism was found in only one case. There was considerable overlap in the serum PRL concentration of patients with galactorrhea with levels found in normal women. The overlap in individuals serum PRL levels in the two groups with galatorrhea did not permit to identify the etiology of the hyperprolactinemia; however, patients with pituitary tumor had the highest PRL levels. PRL responses to L DOPA and CPZ administration did not distinguish patients with tumor from those with galactorrhea of other etiologies. PRL secretion after TRH administration was lower in cases of tumor than in idiopathic galactorrhea; on the other hand the TSH response to TRH did not differ between these two groups. Patients with pituitary tumors had low concentration of basal LH and FSH. Gonadotropin secretion after administration of LH RH varied widely; however cases with pituitary tumor exhibited the lowest response or no response to LH RH. It is concluded that basal PRL values and PRL responses to L DOPA and CPZ administration does not distinguish patients with pituitary tumors from those with idiopathic galactorrhea. Conversely, the administration of LH RH and TRH may be helpful in separating patients with pituitary tumor from those with galactorrhea of other causes. High basal PRL levels associated with a deficient secretion to TRH and absent or deficient secretion of both LH and FSH in response to LH RH could be indicative of an underlying tumor even in the absence of deformity of the sella turcica. Present study also confirms the inadequecy of the eponymic classification and emphasizes the need for close endocrinologic and radiologic follow up of all cases of nonpuerperal galactorrhea.
|Original language||English (US)|
|Number of pages||11|
|State||Published - Dec 1 1974|
ASJC Scopus subject areas
- Endocrinology, Diabetes and Metabolism