Clinical inquiries. What is the recommended evaluation and treatment for elevated serum prolactin? - PubMed

Affiliations

• PMID: 16202380

Review

Clinical inquiries. What is the recommended evaluation and treatment for elevated serum prolactin?

Jo Jackson et al. J Fam Pract. 2005 Oct.

Abstract

History and physical examination can distinguish among most physiologic, pharmacologic, or pathologic causes of an elevated serum prolactin level (SPL) (strength of recommendation [SOR]: C, expert opinion). Patients with unexplained elevations of serum prolactin or with a level above 200 ng/mL should undergo imaging of the sella turcica (SOR: C, expert opinion). Mildly elevated SPL due to physiologic causes may be managed expectantly (SOR: B, cohort studies) and pharmacologic elevations may be treated by discontinuing the causative medication (SOR: C, expert opinion). Elevated SPL due to pathologic causes requires both monitoring for complications and treatment of the underlying condition (SOR: C, expert opinion). Dopamine agonists are effective for patients requiring drug treatment (SOR: B, systematic review of cohort studies), and cabergoline is more effective and better tolerated than bromocriptine (SOR: B, randomized controlled trial [RCT]). Surgery is reserved for symptomatic patients not controlled medically (SOR: C, expert opinion).

Similar articles

• The diagnostic importance of prolactin subgroups in patients with stalk mass.

  Bagdatoglu C, Ay A, Bagdatoglu OT, Ozer C, Polat G, Koksel T. Bagdatoglu C, et al. Acta Neurochir (Wien). 2005 Feb;147(2):209-10. doi: 10.1007/s00701-004-0382-5. Acta Neurochir (Wien). 2005. PMID: 15647889

• Hyperprolactinemia: etiology, diagnosis, and management.

  Mah PM, Webster J. Mah PM, et al. Semin Reprod Med. 2002 Nov;20(4):365-74. doi: 10.1055/s-2002-36709. Semin Reprod Med. 2002. PMID: 12536359 Review.

• Prolactin-secreting tumors: what's new?

  Molitch ME. Molitch ME. Expert Rev Anticancer Ther. 2006 Sep;6 Suppl 9:S29-35. doi: 10.1586/14737140.6.9s.S29. Expert Rev Anticancer Ther. 2006. PMID: 17004854 Review.

• Nomifensine test does not differentiate hyperprolactinemia associated with and without radiologic abnormalities in the sella turcica.

  Canales ES, Cano C, Ablanedo J, Zárate A. Canales ES, et al. Horm Res. 1981;15(4):213-7. doi: 10.1159/000179458. Horm Res. 1981. PMID: 6927819

• Approach to the patient with persistent hyperprolactinemia and negative sellar imaging.

  Glezer A, Bronstein MD. Glezer A, et al. J Clin Endocrinol Metab. 2012 Jul;97(7):2211-6. doi: 10.1210/jc.2011-2976. J Clin Endocrinol Metab. 2012. PMID: 22774208 Review.

Publication types

MeSH terms

Substances

LinkOut - more resources

• Full Text Sources

  • Frontline Medical Communications Inc
  • Ovid Technologies, Inc.