new_n_lost
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A 32 year-old woman presents with a one year history of secondary amenorrhea. She had been prescribed temazepam and dihydrocodeine. On examination she had galactorrhea. Her serum prolactin was noted to be 6000 mU/l (<450 mU/l).
What is the most likely diagnosis?
1) Drug-induced hyperprolactinemia
2) Hypothyroidism
3) Pituitary dependent Cushing's disease
4) Pituitary micro adenoma
5) Stress
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| rock
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4-pituitary microadenoma?
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| keepgoing
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4
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| new_n_lost
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The patient has amenorrhea, galactorrhea and a grossly elevated prolactin concentration of 6000. The diagnosis is likely to be a prolactinoma most likely due to a pituitary microadenoma (microprolactinoma).
These drugs would not cause hyperprolactinemia – drugs that are responsible include dopamine antagonists – Antipsychotics (Haloperidol, Sulpiride), metoclopramide, Domperidone and SSRIs to a lesser extent.
There is nothing in this patient’s history to suggest either hypothyroidism or Cushing’s.
Hypothyroidism may cause hyperprolactinemia but is usually mild. Stress would not produce such a picture.
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FORUM RULES-- Those who believe in telekinesis, raise my hand. I get enough exercise just by pushing my luck --P4U World.." The pure and simple truth is rarely pure and never simple."
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| new_n_lost
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Posts: 6,086
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___________________
FORUM RULES-- Those who believe in telekinesis, raise my hand. I get enough exercise just by pushing my luck --P4U World.." The pure and simple truth is rarely pure and never simple."
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