Prolactinoma differential diagnosis: Difference between revisions

Jump to navigation Jump to search
No edit summary
mNo edit summary
Line 16: Line 16:
***[[Somatotroph adenoma]]: [[Acromegaly]]
***[[Somatotroph adenoma]]: [[Acromegaly]]
***[[ACTH-secreting tumor|Corticotroph adenoma]]: [[Cushing's syndrome]]
***[[ACTH-secreting tumor|Corticotroph adenoma]]: [[Cushing's syndrome]]
***Supra [[Sella turcica|seller]] tumors(tumors present in region of [[pituitary stalk]])
**Supra [[Sella turcica|seller]] tumors(tumors present in region of [[pituitary stalk]])
**[[Hypothyroidism]]<ref name="pmid4199418">{{cite journal| author=Snyder PJ, Jacobs LS, Utiger RD, Daughaday WH| title=Thyroid hormone inhibition of the prolactin response to thyrotropin-releasing hormone. | journal=J Clin Invest | year= 1973 | volume= 52 | issue= 9 | pages= 2324-9 | pmid=4199418 | doi=10.1172/JCI107421 | pmc=333037 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=4199418  }} </ref>
**[[Hypothyroidism]]<ref name="pmid4199418">{{cite journal| author=Snyder PJ, Jacobs LS, Utiger RD, Daughaday WH| title=Thyroid hormone inhibition of the prolactin response to thyrotropin-releasing hormone. | journal=J Clin Invest | year= 1973 | volume= 52 | issue= 9 | pages= 2324-9 | pmid=4199418 | doi=10.1172/JCI107421 | pmc=333037 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=4199418  }} </ref>
**[[Chronic renal failure]]<ref name="pmid7372775">{{cite journal| author=Sievertsen GD, Lim VS, Nakawatase C, Frohman LA| title=Metabolic clearance and secretion rates of human prolactin in normal subjects and in patients with chronic renal failure. | journal=J Clin Endocrinol Metab | year= 1980 | volume= 50 | issue= 5 | pages= 846-52 | pmid=7372775 | doi=10.1210/jcem-50-5-846 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=7372775  }} </ref>
**[[Chronic renal failure]]<ref name="pmid7372775">{{cite journal| author=Sievertsen GD, Lim VS, Nakawatase C, Frohman LA| title=Metabolic clearance and secretion rates of human prolactin in normal subjects and in patients with chronic renal failure. | journal=J Clin Endocrinol Metab | year= 1980 | volume= 50 | issue= 5 | pages= 846-52 | pmid=7372775 | doi=10.1210/jcem-50-5-846 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=7372775  }} </ref>
**[[Hepato-biliary diseases|Liver disease]]<ref name="pmid26958514">{{cite journal| author=Jha SK, Kannan S| title=Serum prolactin in patients with liver disease in comparison with healthy adults: A preliminary cross-sectional study. | journal=Int J Appl Basic Med Res | year= 2016 | volume= 6 | issue= 1 | pages= 8-10 | pmid=26958514 | doi=10.4103/2229-516X.173984 | pmc=4765284 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26958514  }} </ref>
**[[Hepato-biliary diseases|Liver disease]]<ref name="pmid26958514">{{cite journal| author=Jha SK, Kannan S| title=Serum prolactin in patients with liver disease in comparison with healthy adults: A preliminary cross-sectional study. | journal=Int J Appl Basic Med Res | year= 2016 | volume= 6 | issue= 1 | pages= 8-10 | pmid=26958514 | doi=10.4103/2229-516X.173984 | pmc=4765284 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26958514  }} </ref>
**[[Cirrhosis]](with or without [[encephalopathy]])
***[[Cirrhosis]](with or without [[encephalopathy]])
**[[Viral hepatitis]](with [[encephalopathy]])
***[[Viral hepatitis]](with [[encephalopathy]])
**[[Seizure|Seizure disorder]]<ref name="Ben-Menachem2006">{{cite journal|last1=Ben-Menachem|first1=Elinor|title=Is Prolactin a Clinically Useful Measure of Epilepsy?|journal=Epilepsy Currents|volume=6|issue=3|year=2006|pages=78–79|issn=1535-7597|doi=10.1111/j.1535-7511.2006.00104.x}}</ref><ref name="pmid737437">{{cite journal| author=Trimble MR| title=Serum prolactin in epilepsy and hysteria. | journal=Br Med J | year= 1978 | volume= 2 | issue= 6153 | pages= 1682 | pmid=737437 | doi= | pmc=1608938 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=737437  }} </ref>
**[[Seizure|Seizure disorder]]<ref name="Ben-Menachem2006">{{cite journal|last1=Ben-Menachem|first1=Elinor|title=Is Prolactin a Clinically Useful Measure of Epilepsy?|journal=Epilepsy Currents|volume=6|issue=3|year=2006|pages=78–79|issn=1535-7597|doi=10.1111/j.1535-7511.2006.00104.x}}</ref><ref name="pmid737437">{{cite journal| author=Trimble MR| title=Serum prolactin in epilepsy and hysteria. | journal=Br Med J | year= 1978 | volume= 2 | issue= 6153 | pages= 1682 | pmid=737437 | doi= | pmc=1608938 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=737437  }} </ref>
*'''Medication-induced:'''
*'''Medication-induced:'''

Revision as of 13:53, 21 July 2017

Prolactinoma Microchapters

Home

Patient Information

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Prolactinoma from other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

Diagnosis

History and Symptoms

Physical Examination

Laboratory Findings

ECG

X-ray

Ultrasound

CT

MRI

Other Imaging Findings

Other Diagnostic Studies

Treatment

Medical Therapy

Surgery

Primary Prevention

Secondary Prevention

Cost-Effectiveness of Therapy

Future or Investigational Therapies

Case Studies

Case #1

Prolactinoma differential diagnosis On the Web

Most recent articles

Most cited articles

Review articles

CME Programs

Powerpoint slides

Images

American Roentgen Ray Society Images of Prolactinoma differential diagnosis

All Images
X-rays
Echo & Ultrasound
CT Images
MRI

Ongoing Trials at Clinical Trials.gov

US National Guidelines Clearinghouse

NICE Guidance

FDA on Prolactinoma differential diagnosis

CDC on Prolactinoma differential diagnosis

Prolactinoma differential diagnosis in the news

Blogs on Prolactinoma differential diagnosis

Directions to Hospitals Treating Prolactinoma

Risk calculators and risk factors for Prolactinoma differential diagnosis

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Anmol Pitliya, M.B.B.S. M.D.[2]

Overview

Prolactinoma must be differentiated from other causes of hyperprolactinemia.

Causes of hyperprolactinemia can be categorized as physiological, pathological and medication-induced.

Differential Diagnosis

Prolactinoma must be differentiated from other causes of hyperprolactinemia that may present as galactorrhea, amenorrhea (in females) and infertility (in both males and females) including:

Prolactinoma must be differentiated from causes of hyperprolactinemia
Disease Clinical Findings Laboratory findings Management
Somatotroph adenoma:

Acromegaly

Clinical features of acromegaly are due to high level of human growth hormone(hGH):
  • Soft tissue swelling of the hands and feet
  • Surgical management:
    • Endonasal transsphenoidal surgery
  • Radiation therapy
Corticotroph adenoma: Cushing's syndrome Clinical features of Cushing's syndrome are due to increased level of cortisol:
  • Dexamethasone suppression test
  • 24 hour urinary measurement of cortisol
Hypothyroidism Clinical features of hypothyroidism are due to deficiency of thyroxine:
  • Fullness in the throat and neck
  • Elevated TSH
  • Low T4
  • Low T3
  • Elevated Anti-thyroid antibodies(TPOAb)
Levothyroxine
Chronic renal failure There are no pathognomonic symptoms associated with chronic renal failure. Common non-specific symptoms of chronic renal failure includes: Urinalysis:

Fluid and Electrolyte disturbances:

Endocrine and Metabolic disturbances

Hematologic abnormalities

Liver disease: Cirrhosis The clinical features of liver cirrhosis are very non-specific. These includes: Elevated aminotransferases (AST & ALT)

Elevated alkaline phosphatase (ALP)

Elevated gamma-glutamyl transpeptidase

Elevated bilirubin

Low albumin

Elevated prothrombin time

Elevated globulin

Hyponatremia

Anemia

Leukopenia and neutropenia

Thrombocytopenia

Seizure disorder The clinical feature of seizure disorder includes:
  • Change in alertness; the person cannot remember a period of time
  • Mood changes, such as unexplainable fear, panic, joy, or laughter
  • Change in sensation of the skin, usually spreading over the arm, leg, or trunk
  • Vision changes, including seeing flashing lights
  • Rarely, hallucinations (seeing things that aren't there)
  • Falling, loss of muscle control, occurs very suddenly
  • Muscle twitching that may spread up or down an arm or leg
  • Muscle tension or tightening that causes twisting of the body, head, arms, or legs
  • Shaking of the entire body
  • Tasting a bitter or metallic flavor
Electroencephalogram
Medication-induced Clinical features of hyperprolactinemia after a specific period of regular medication ingestion Stop the medication and see if symptoms resolve Change to alternate medication

References

  1. Rigg LA, Lein A, Yen SS (1977). "Pattern of increase in circulating prolactin levels during human gestation". Am J Obstet Gynecol. 129 (4): 454–6. PMID 910825.
  2. Levy A (2004). "Pituitary disease: presentation, diagnosis, and management". J Neurol Neurosurg Psychiatry. 75 Suppl 3: iii47–52. doi:10.1136/jnnp.2004.045740. PMC 1765669. PMID 15316045.
  3. Snyder PJ, Jacobs LS, Utiger RD, Daughaday WH (1973). "Thyroid hormone inhibition of the prolactin response to thyrotropin-releasing hormone". J Clin Invest. 52 (9): 2324–9. doi:10.1172/JCI107421. PMC 333037. PMID 4199418.
  4. Sievertsen GD, Lim VS, Nakawatase C, Frohman LA (1980). "Metabolic clearance and secretion rates of human prolactin in normal subjects and in patients with chronic renal failure". J Clin Endocrinol Metab. 50 (5): 846–52. doi:10.1210/jcem-50-5-846. PMID 7372775.
  5. Jha SK, Kannan S (2016). "Serum prolactin in patients with liver disease in comparison with healthy adults: A preliminary cross-sectional study". Int J Appl Basic Med Res. 6 (1): 8–10. doi:10.4103/2229-516X.173984. PMC 4765284. PMID 26958514.
  6. Ben-Menachem, Elinor (2006). "Is Prolactin a Clinically Useful Measure of Epilepsy?". Epilepsy Currents. 6 (3): 78–79. doi:10.1111/j.1535-7511.2006.00104.x. ISSN 1535-7597.
  7. Trimble MR (1978). "Serum prolactin in epilepsy and hysteria". Br Med J. 2 (6153): 1682. PMC 1608938. PMID 737437.
  8. David SR, Taylor CC, Kinon BJ, Breier A (2000). "The effects of olanzapine, risperidone, and haloperidol on plasma prolactin levels in patients with schizophrenia". Clin Ther. 22 (9): 1085–96. doi:10.1016/S0149-2918(00)80086-7. PMID 11048906.
  9. McCallum RW, Sowers JR, Hershman JM, Sturdevant RA (1976). "Metoclopramide stimulates prolactin secretion in man". J Clin Endocrinol Metab. 42 (6): 1148–52. doi:10.1210/jcem-42-6-1148. PMID 777023.
  10. Sowers JR, Sharp B, McCallum RW (1982). "Effect of domperidone, an extracerebral inhibitor of dopamine receptors, on thyrotropin, prolactin, renin, aldosterone, and 18-hydroxycorticosterone secretion in man". J Clin Endocrinol Metab. 54 (4): 869–71. doi:10.1210/jcem-54-4-869. PMID 7037817.
  11. Steiner J, Cassar J, Mashiter K, Dawes I, Fraser TR, Breckenridge A (1976). "Effects of methyldopa on prolactin and growth hormone". Br Med J. 1 (6019): 1186–8. PMC 1639736. PMID 1268617.
  12. Fearrington EL, Rand CH, Rose JD (1983). "Hyperprolactinemia-galactorrhea induced by verapamil". Am J Cardiol. 51 (8): 1466–7. PMID 6682619.

Template:WikiDoc Sources