Research Article| Volume 1, ISSUE 4, P262-266, 1988

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Presentation and evaluation of hyperprolactinemia in adolescence: Case reports and suggested clinical guidelines

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      We describe the presentation, clinical evaluation, and outcome of 3 cases of hyperprolactinemia in adolescent females. Case #1 is a 16 and 4/12-year-old female with secondary amenorrhea. Pregnancy testing had previously been negative with no further evaluation. Bilateral expressible galactorrhea was discovered on physical examination and a serum prolactin was 110.3 ng/ml. The computed tomography (CT) scan was normal and menses resumed with bromocriptine therapy. Case #2 is a 15 and Vi2-year-old female who came for a routine yearly examination. She had no complaint and was menstruating regularly. Specific questioning revealed a history of galactorrhea confirmed by physical examination. A serum prolactin was 47.0 ng/ml. A CT scan showed a pituitary microadenoma. She was treated with bromocriptine. Case #3 is a 16 and 9/12-year-old female who was seen for primary amenorrhea. An evaluation revealed a serum prolactin of 143.0 ng/ml. A CT scan showed a pituitary microadenoma. She was treated with bromocriptine and began to menstruate regularly. For the physician seeing the adolescent female, thorough medical histories must include questions regarding the breast, and evaluation for galactorrhea must be part of every breast examination. The physician also needs to be familiar with the evaluation of amenorrhea and/or galactorrhea and include determination of serum prolactin when indicated. We recommend obtaining a constant enhanced CT scan or magnetic resonance imaging (MRI) of the sella turcica to evaluate any elevation of serum prolactin.

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