Summary
Definition
History and exam
Key diagnostic factors
- presença de fatores de risco
- amenorreia ou oligomenorreia
- infertilidade
- galactorreia
- perda do desejo sexual (libido)
- disfunção erétil
- deterioração visual (por exemplo, hemianopsia temporal)
Other diagnostic factors
- osteoporose
- oftalmoplegia
- cefaleias
Risk factors
- predisposição genética (por exemplo, presença de mutação resultando em neoplasia endócrina múltipla-1 [NEM-1], adenoma hipofisário familiar isolado [FIPA])
- terapia estrogênica
- sexo masculino, de 30 a 60 anos de idade
- sexo feminino, de 20 a 50 anos de idade
Diagnostic tests
1st tests to order
- prolactina sérica
- ressonância nuclear magnética (RNM) da hipófise
- exame do campo visual computadorizado
Treatment algorithm
mulheres na pré-menopausa
mulheres menopausadas
homens
Contributors
Authors
Niamh Martin, MB ChB, PhD, FRCP
Reader in Endocrinology
Imperial Centre for Endocrinology
Department of Metabolism, Digestion and Reproduction
Imperial College London
London
UK
Disclosures
NM declares that she has no competing interests.
Acknowledgements
Dr Niamh Martin would like to gratefully acknowledge Dr Ilan Shimon, the previous contributor to this topic.
Disclosures
IS receives consultancy and lecturing fees from Pfizer, Israel, and is an author of a number of references cited in this topic.
Peer reviewers
Mark Molitch, MD
Professor
Division of Endocrinology
Northwestern University Feinberg School of Medicine
Chicago
IL
Disclosures
MM is an author of a number of references cited in this topic.
References
Key articles
Wildemberg LE, Fialho C, Gadelha MR. Prolactinomas. Presse Med. 2021 Dec;50(4):104080.Full text Abstract
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.Full text Abstract
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. Abstract
Reference articles
A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
Differentials
- Macroadenomas hipofisários não funcionantes
- Hiperprolactinemia induzida por medicamentos
- Hipotireoidismo primário
More DifferentialsGuidelines
- Position statement for clinical practice: prolactin-secreting tumors
- ACR appropriateness criteria: neuroendocrine imaging
More Guidelines
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