小结
定义
病史和体格检查
关键诊断因素
- presence of risk factors
- amenorrhoea or oligomenorrhoea
- infertility
- galactorrhoea
- loss of sexual desire (libido)
- erectile dysfunction
- visual deterioration (e.g., temporal hemianopia)
其他诊断因素
- osteoporosis
- ophthalmoplegia
- headaches
危险因素
- genetic predisposition (e.g., presence of mutation resulting in multiple endocrine neoplasia-1 [MEN-1], familial isolated pituitary adenoma [FIPA])
- oestrogen therapy
- male sex, 30 to 60 years of age
- female sex, 20 to 50 years of age
诊断性检查
首要检查
- serum prolactin
- pituitary MRI
- computerised visual-field examination
治疗流程
pre-menopausal women
post-menopausal women
men
撰稿人
作者
Niamh Martin, MB ChB, PhD, FRCP
Reader in Endocrinology
Imperial Centre for Endocrinology
Department of Metabolism, Digestion and Reproduction
Imperial College London
London
UK
利益声明
NM declares that she has no competing interests.
鸣谢
Dr Niamh Martin would like to gratefully acknowledge Dr Ilan Shimon, the previous contributor to this topic.
利益声明
IS receives consultancy and lecturing fees from Pfizer, Israel, and is an author of a number of references cited in this topic.
同行评议者
Mark Molitch, MD
Professor
Division of Endocrinology
Northwestern University Feinberg School of Medicine
Chicago
IL
利益声明
MM is an author of a number of references cited in this topic.
Peer reviewer acknowledgements
BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.
Disclosures
Peer reviewer affiliations and disclosures pertain to the time of the review.
参考文献
关键文献
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.全文 摘要
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. 摘要
参考文献
A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
鉴别诊断
- Non-functioning pituitary macroadenomas
- Drug-induced hyperprolactinaemia
- Primary hypothyroidism
更多 鉴别诊断გაიდლაინები
- Position statement for clinical practice: prolactin-secreting tumors
- ACR appropriateness criteria: neuroendocrine imaging
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