Name
PROLACTIN DEFICIENCY
DESCRIPTION
DETAIL
PROLACTIN DEFICIENCY CAUSES ONLY PUERPERAL ALACTOGENESIS CAUSES : 1. ISOLATED LROLACTIN DEFICIENCY - FAMILIAL PUERPERAL ALACTOGENESIS ( HAVING GENETIC COMPONENT ) 2. SECONDARY TO ANT PITUITARY DYSFUNCTION * > 90% HAVE PITUITARY DISEASE LIKE - TUMOR LIKE * CRANIOPHARYNGIOMA * ADENOMA - SURGERY - IRRADIATION - ISCHEMIA OR INFARCTION LIKE * SHEEHAN SYNDROME * APOPLEXY - TRAUMA - INFILTRATIVE DISEASES LIKE * SARCOIDOSIS * HISTIOCYTOSIS X DISEASE * HEMOCHROMATOSIS - INFECTIONS LIKE * TUBERCULOSIS * SYPHILIS * MENINGITIS - AUTOIMMUNE * LYMPHOCYTIC INFILTRATION ( LYMPHOCYTIC HYPOPHYSITIS ) - IDIOPATHIC 3. OTHER CAUSES - MEDICATIONS LIKE * DOPAMINE INFUSION, ERGOT PREPARATIONS, PYRIDOXINE, DIURETICS, NICOTINE - BULIMIA - RETAINED PLACENTAL FRAGMENTS IN THE PERIPARTUM INTERVAL - ASSOCIATED WITH G-PROTEIN MUTATIONS LIKE ALBRIGHT HEREDITARY OSTEODYSTROPHY - MULTIPLE PITUITARY HORMONE DEFICIENCY ( RARE HEREDITARY DISORDER ASSOCIATED WITH GH, TSH & PROLACTIN DEFICIENCY)INVESTIGATIONS DEPENDS ON THE CAUSE OF THE DEFICIENCY * MRI SELLA TURSICA REGION * PROLACTIN IS SECRETED IN PULSATILE MANNER, LOWEST AT MIDDAY, & MODEST INCREASE OCCUR DURING THE AFTERNOON, INCREASES SHORTLY AFTER SLEEP( 60-90 MTS ), PEAKING IN EARLY MORNING. ITS LEVEL RISES TO STRESS, FOOD, SEROTONIN, ACETYLCHOLINE, OPIATES, ESTROGENS, TRH & ANGIOTENSIN II.
TYPENOTES
Currently, no medication exists to treat prolactin deficiency; however, experimental recombinant human prolactin has been formulated and shown to be effective in correcting lactational performance in rats treated with bromocriptine. Inadequate lactation may respond to antidopaminergic agents that block the dopamine-induced hypothalamic inhibitory control of prolactin. Metoclopramide has been shown in prospective placebo-controlled studies to significantly increase milk yield in patients with inadequate lactation. Subfertility caused by hypoprolactinemia may be treated with clomiphene citrate (50 mg/d for 5 d) or with gonadotropins (LH, FSH; dose varies).
RELATED DISEASE
Not Available Disease
DISEASE
INVESTIGATION
SERUM PROLACTIN ( NONPREGNANT FEMALE ), SERUM PROLACTIN ( PREGNANT FEMALE ), CT SCAN HEAD, COMPLETE BLOOD COUNT, MRI