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Symptoms and Signs – Differential Diagnosis of Hyperprolactinaemia
Physiological: pregnancy, lactation, stress
Prolactinoma, rarely ectopic prolactin (lung, kidney tumours)
Reduced Dopamine transport to the anterior pituitary: pituitary tumour compressing
pituitary stalk (pseudoprolactinoma affect)
Drugs:
Depletion of central dopamine stores: reserpine, methyldopa
Dopamine receptor blockers: (chlorpromazine, haloperidol, sulpiride,
metoclopramide, domperidone)
Increased TRH secretion stimulates prolactin release (1° hypothyroidism)
Oestrogens: HRT/OCP, PCOS (oestrogen stimulates lactotrophs)
Chest wall injury (stimulation of the reflex pathway normally activated by
suckling in lactating women)
Others: liver failure, l dopamine synthesis/release from the hypothalamus
(tumour, inflammation, arteriovenous malformations)·
Physiological: pregnancy, lactation, stress
Prolactinoma, rarely ectopic prolactin (lung, kidney tumours)
Reduced Dopamine transport to the anterior pituitary: pituitary tumour compressing
pituitary stalk (pseudoprolactinoma affect)
Drugs:
Depletion of central dopamine stores: reserpine, methyldopa
Dopamine receptor blockers: (chlorpromazine, haloperidol, sulpiride,
metoclopramide, domperidone)
Increased TRH secretion stimulates prolactin release (1° hypothyroidism)
Oestrogens: HRT/OCP, PCOS (oestrogen stimulates lactotrophs)
Chest wall injury (stimulation of the reflex pathway normally activated by
suckling in lactating women)
Others: liver failure, l dopamine synthesis/release from the hypothalamus
(tumour, inflammation, arteriovenous malformations)·
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