Resumen
Definición
Anamnesis y examen
Principales factores de diagnóstico
- amenorrhea or oligomenorrhea
- infertility
- galactorrhea
- loss of sexual desire (libido)
- erectile dysfunction
- visual deterioration (e.g., temporal hemianopia)
Otros factores de diagnóstico
- osteoporosis
- ophthalmoplegia
- headaches
Factores de riesgo
- genetic predisposition (e.g., presence of mutation resulting in multiple endocrine neoplasia-1 [MEN-1], familial isolated pituitary adenoma [FIPA])
- estrogen therapy
- male sex, 30 to 60 years of age
- female sex, 20 to 50 years of age
Pruebas diagnósticas
Primeras pruebas diagnósticas para solicitar
- serum prolactin
- pituitary MRI
- computerized visual-field examination
Algoritmo de tratamiento
premenopausal women
postmenopausal women
men
Colaboradores
Autores
Niamh Martin, MB ChB, PhD, FRCP
Reader in Endocrinology
Imperial Centre for Endocrinology
Department of Metabolism, Digestion and Reproduction
Imperial College London
London
UK
Divulgaciones
NM declares that she has no competing interests.
Agradecimientos
Dr Niamh Martin would like to gratefully acknowledge Dr Ilan Shimon, the previous contributor to this topic.
Divulgaciones
IS receives consultancy and lecturing fees from Pfizer, Israel, and is an author of a number of references cited in this topic.
Revisores por pares
Mark Molitch, MD
Professor
Division of Endocrinology
Northwestern University Feinberg School of Medicine
Chicago
IL
Divulgaciones
MM is an author of a number of references cited in this topic.
Referencias
Artículos principales
Wildemberg LE, Fialho C, Gadelha MR. Prolactinomas. Presse Med. 2021 Dec;50(4):104080.Texto completo Resumen
Melmed S, Casanueva FF, Hoffman AR, et al; Endocrine Society. Diagnosis and treatment of hyperprolactinemia: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab. 2011 Feb;96(2):273-88.Texto completo Resumen
Xia MY, Lou XH, Lin SJ, et al. Optimal timing of dopamine agonist withdrawal in patients with hyperprolactinemia: a systematic review and meta-analysis. Endocrine. 2018 Jan;59(1):50-61. Resumen
Artículos de referencia
Una lista completa de las fuentes a las que se hace referencia en este tema está disponible para los usuarios con acceso a todo BMJ Best Practice.
Diferenciales
- Nonfunctioning pituitary macroadenomas
- Drug-induced hyperprolactinemia
- Primary hypothyroidism
Más DiferencialesGuías de práctica clínica
- ACR appropriateness criteria: neuroendocrine imaging
- Clinical practice guidelines for the management of aggressive pituitary tumours and carcinomas
Más Guías de práctica clínica
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