Hyperprolactinemia

Overview hyperprolactinemia (Hyperpro - lactinemia convenient in usage, low). means by the internal and external environment factors, increased to PRL (≥ 25ng/ml), amenorrhea, galactorrhea, without ovulation and infertility syndrome characterized. Nearly 20 years, PRL on the physiological and biochemical research has made tremendous progress, and PRL RIA determination Brain CT and MRI technology progress and improving the sterility of diagnosis, the incidence has increased trend. Meanwhile anti-drug bromocriptine prolactin (Bromocriptine. Parlodel) and the advent of transsphenoidal microsurgery carried out so that the diagnosis and treatment of sterility created a new situation. Cause pathogenesis normal pulse PRL release and its circadian rhythm right breast development, lactation ovarian function and play an important regulatory role. PRL secretion by the hypothalamus PRL-RH and PRL-IH double-conditioning, In normal ovulatory menstrual cycle PRL remain under CNS dopamine neurons in the hypothalamus and medium PRL-IH Zhang Inhibition of sexual adjustment under this regulation if the imbalance is caused by HPPL. Bags may be living a rational and disease caused by irrational factors. 1, physiological hyperprolactinemia (1) night and sleep (2 ~ 6Am). (2) egg and luteal phase. (3) pregnancy : higher than that of non-pregnant ≥ 10 times. (D) lactation period : by massage, nipple sucking cause acute, short-term or continuous increase in the secretion. (5) puerperium : 3 ~ 4 weeks. (6) hypoglycemia. (7) Movement and the stress. (8) sexual intercourse : orgasm increased significantly. (9) fetal and neonatal (≥ 28 gestational weeks postpartum 2 ~ ~ 3 weeks). 2, pathologic hyperprolactinemia (1) of hypothalamic-pituitary lesion 1. Tumor : non-functional -- craniopharyngioma, Sarcoma-like disease (sarcoid) glial cell tumors. Functional -- PRL 46%; GH adenoma 22 ~ 31%. PRL - GH adenoma 5 ~ 7%; ACTH adenoma & Nelson's syndrome4 ~ 15%. Multifunctional adenoma 10%; Undifferentiated : 19 ~ 27%. 2. Inflammation : Skull Base meningitis, tuberculosis, syphilis, actinomycosis. 3. Damage : injury, surgery, a move venous malformation, granulomatous disease (Hand-Schüller-Christian's syndrome). 4. Empty sella syndrome. 5. Pituitary stalk disease, injury or tumor suppression. 6. Trauma and stress. 7. Parkinson's disease. (2) primary and / or secondary hypothyroidism. 1. Pseudohypoparathyroidism (Pseudo-parathyroidism). 2. Hashimoto's thyroiditis (Hashimoto's thyroiditis). (3) ectopic PRL secretion syndrome : undifferentiated bronchial lung, adrenal carcinoma, embryonal carcinoma. (4) adrenal and kidney diseases : Adisen's disease, chronic renal failure. (5) polycystic ovary syndrome. (6) cirrhosis. (7) gynecologic surgery : abortion, induced abortion, stillbirth, hysterectomy, tubal ligation, ovarian surgery. (8) The local stimulation : papillitis, the lesion, chest trauma, herpes zoster, tuberculosis, surgery. (9) The Medical sources - drug factors : 1. Insulin-induced hypoglycemia. 2. Sex hormones (estrogen-progestogen contraceptives). 3. Synthesis of TSH-RH. 4. Anesthetics : morphine, methadone, methionine enkephalin. 5. Dopamine receptor antagonist : Phenothiazones, Haloperidol, Metoclprimide, Domperidone, Pimozide. Sulpiride. 6. Re-absorption of dopamine antagonist : Nomifensine. 7.CNS dopamine degradation agent : reserpine, amethyl-counts. 8. Into dopamine inhibitors : A peptide. 9. Monoamine oxidase inhibitor. 10. Diphenyl nitrogen derivatives : diphenyl oxazole Nitrogen, carbamoyl nitrogen, and dereliction of Kingston, imipramine (imipramine), A secret for forest (Amitriptyline) phenytoin because (phenytoin) stability and chlorine Nithrazepam (Clonazepam). 11. Histamine and histamine H1, H2 receptor antagonist : 5-HT, Amphetamines, Hallucinogens H1 receptor antagonist (chlorobenzene A meclizine hydrochloride, Topiramate benzyl that Pyribenzamine) H2 receptor antagonist (A microphone physically Cimitidine cyanide). (10) Idiopathic.