Gyn Hyperprolactinemia

Hyperprolactinemia Dr. Ashraf Fouda F.E.B.O.G. Obs./Gyn. Consultant

[object Object],[object Object],[object Object],PROLACTIN

[object Object],[object Object],[object Object],[object Object],PROLACTIN

PROLACTIN ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

[object Object],[object Object],[object Object],Pathophysiology

[object Object],[object Object],Pathophysiology

Manifestation of hyperprolactinemia ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Manifestation of hyperprolactinemia

Hyperprolactinaemia ,[object Object],[object Object],[object Object],[object Object]

Causes of hyperprolactinemia ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Idiopathic hyperprolactinemia

[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Drug-induced hyperprolactinemia

[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Drug-induced hyperprolactinemia

Hypothalamic Causes ,[object Object],[object Object]

Pituitary Causes ,[object Object],[object Object],[object Object],[object Object],[object Object]

[object Object],Empty sella syndrome

Hypothyroidism ,[object Object]

[object Object],[object Object],[object Object],[object Object],[object Object],Indications for Prolactin assay Not all hyperprolactinemic patients display galactorrhea and galactorrhea can be seen with normal prolactin level

Indications for sella evaluation ,[object Object],[object Object],[object Object],[object Object],[object Object]

Galactorrhea ,[object Object],[object Object]

[object Object],[object Object],Galactorrhea

If no obvious cause is identified or if a tumor is suspected, MRI should be performed. ,[object Object],[object Object],[object Object],[object Object]

[object Object],[object Object],If no obvious cause is identified or if a tumor is suspected, MRI should be performed.

Macroprolactinemia ,[object Object],[object Object],[object Object],[object Object]

[object Object],[object Object],[object Object],Macroprolactinemia

Imaging Studies ,[object Object],[object Object]

[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Management

[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Medical treatment

[object Object],[object Object],[object Object],Medical treatment goals

Dopamine agonists ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Dopamine agonists NB: Parlodel  GH in healthy and  it in acromegalics 1 mg/week 75  g/day 0.1 mg/day 7.5 mg/d Maintenance 0.25-1 mg/TWW 25-300  g/day 0.1-0.2 mg/day 2.5-10 mg/day Dose Ergot Cabergoline (Dostinex) Ergot Quinagolide (Norprolac) Ergot Lisuride (Dopergine) Ergot Bromocriptine (Parlodel) Nature Agonist

Bromocriptine ,[object Object],[object Object],[object Object]

[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Bromocriptine

[object Object],[object Object],[object Object],[object Object],Bromocriptine

[object Object],[object Object],[object Object],Bromocriptine

[object Object],[object Object],Bromocriptine

Drugs safety in Pregnancy FDA system for classifying drugs based on potential to cause birth defects (1996) A B C D E No Risk Animal: No Risk Human: Not Adequate Animal: Toxicity Human: Not Adequate Human: Risk Human: Great Risk

Cabergoline ,[object Object],[object Object],[object Object]

[object Object],[object Object],Cabergoline

Surgical Care ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Radiotherapy ,[object Object],[object Object]

Key clinical recommendation ,[object Object],[object Object],[object Object],[object Object]

[object Object],[object Object],[object Object],[object Object],Key clinical recommendation

KEY POINTS ,[object Object],[object Object],[object Object]

[object Object],[object Object],KEY POINTS

[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],KEY POINTS

[object Object],[object Object],[object Object],[object Object],KEY POINTS

[object Object],[object Object],[object Object],KEY POINTS

Gyn Hyperprolactinemia

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Gyn Hyperprolactinemia