Which conditions are included in the differential diagnoses of prolactinomas?

Updated: Mar 25, 2018
  • Author: Venkatesh Babu Segu, MD, MBBS, DM; Chief Editor: Romesh Khardori, MD, PhD, FACP  more...
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Answer

If a female patient has amenorrhea, primary or secondary, consider other possible causes of the condition in the differential. If a patient (male or female) presents with infertility, consider all other causes of infertility in the differential.

If a patient has an elevated PRL level, other causes of hyperprolactinemia must be sought. These include the following:

  • Drugs - Such as phenothiazines, haloperidol, metoclopramide, methyldopa, reserpine, verapamil, tricyclic antidepressants, chronic opiate abuse, and cocaine [20]

  • Pituitary or hypothalamic causes - Including GH-secreting adenoma, nonfunctioning adenoma, pituitary stalk compression, empty sella syndrome, craniopharyngioma, meningioma, dysgerminoma, lymphocytic hypophysitis, other granulomatous conditions causing pituitary stalk distortion, and prior radiation to the area

  • Pregnancy

  • Primary hypothyroidism [21]

  • Chronic renal failure

  • Cirrhosis

  • Adrenal insufficiency

  • Chest wall lesions

  • Breast stimulation

  • Spinal cord lesions

  • Idiopathic causes


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