Hyperprolactinemia in A 15-Year-Old Girl with Primary Amenorrhea
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概要
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It is known that hyperprolactinemia in adolescence is a rare cause of delayed or arrested puberty and growth disturbance. We studied the case of a 15-year-old girl with hyperprolactinemia, obesity, short stature and primary amenorrhea. She had had galactorrhea since 13 years of age, and menarche had not yet been seen by the age of 15. Her serum prolactin level was extremely high (328 ng/ml), but the other hormones examined were almost within the normal range. The serum prolactin constantly maintained high levels during Insulin+TRH+LH-RH infusion, indicating no reaction to TRH administration. Her sella turcica was slightly flattened on plain X-ray films. Plain and enhanced computed tomograms (CT) of the head were normal, and the pituitary stalk was seen to have shifted to the right on magnetic resonance imaging (MRI). Her serum prolactin level was reduced to 46.1 ng/ ml by treatment with oral administration of bromocriptine (2.5 mg/day). The level of prolactin was further decreased when the dose of bromocriptine was gradually increased, and galactorrhea almost ceased and menstruation occurred. Prolactinoma in adolescence may also be easily and effectively managed by medical therapy. All clinicians who see patients with arrested puberty and/or primary amenorrhea should therefore be aware of the possibility of this diagnosis.
- 日本小児内分泌学会の論文
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