Analysis of the causes of hyperprolactinemia

What are the causes of hyperprolactinemia? Family members and patients do not know the causes of its onset. Understanding its causes will be of great help in treatment. There are many causes of its onset in life, and we must seriously understand it. Please take a look at the experts' introduction!

What is the cause of hyperprolactinemia?

1. Physiological hyperprolactinemia Many physiological factors can affect the patient's serum PRL level, which changes in different physiological periods, even every day and every hour. Many daily activities, such as physical exercise, mental trauma, hypoglycemia, night, sleep, eating, stress stimulation, sexual intercourse, and physiological phenomena, such as the late follicular and luteal phases, pregnancy, lactation, puerperium, nipple stimulation, neonatal period, etc., can lead to a temporary increase in PRL, but the increase will not be too large, the duration will not be too long, and it will not cause relevant pathological symptoms.

2. Pharmacological hyperprolactinemia Any drug that affects dopamine (DA) metabolism may reduce the effect of DA at the DA receptor level by antagonizing prolactin inhibitory factor (PIF) and enhancing prolactin releasing factor (PRF), thereby promoting PRL secretion and leading to hyperprolactinemia, but it is generally below 100ng/ml.

3. Pathological hyperprolactinemia Common pathological causes of hyperprolactinemia are:

(1) Hypothalamic PIF deficiency or obstruction of the pathway to the pituitary gland causes the normal inhibitory regulation of pituitary PRI cells to be released. This is common in hypothalamic or pituitary stalk lesions, especially in pan-adenohypophysis or when the pituitary stalk is damaged due to trauma or surgery, such as skull base meningitis, tuberculosis, syphilis, actinomycosis, craniopharyngioma, sarcoidosis, glioma, empty sella syndrome, injury, surgery, arteriovenous malformation, Parkinson's disease, and mental trauma.

(2) Primary and/or secondary hypoparathyroidism: such as pseudohypoparathyroidism and Hashimoto's thyroiditis.

(3) Obtaining autonomous high-function PRL-secreting cell monoclonal lines: seen in pituitary PRL adenomas, GH adenomas, ACTH adenomas, etc., as well as heterologous PRL secretion in cancers, such as undifferentiated bronchial lung cancer, adrenal adenomas, embryonal carcinomas, endometriosis, etc.

4. Idiopathic hyperprolactinemia. This type of patient has nothing to do with pregnancy, medication, pituitary tumors or other organic lesions. It is mostly due to hypothalamic-pituitary dysfunction in patients, which leads to increased PRL secretion. Most of them have mildly elevated PRL and a long course of disease, but can return to normal. When there is no medical reason and the cranial magnetic resonance imaging fails to find adenoma, the diagnosis of idiopathic hyperprolactinemia can be confirmed. However, for some patients with menstrual disorders and PRL>100tiglL, it is necessary to be alert to the possibility of latent pituitary microadenoma and should be followed up closely. In addition, hyperprolactinemia is macromolecular PRLemia. Macromolecular PRLemia is a significant increase in PRL in serum, but there are no clinical symptoms. This macromolecular PRL forms an immune complex with its IgG type antibody. Because of its large molecular weight, it cannot pass through the capillary wall and cannot bind to the target cell receptor, so it has no biological effect in the body, but because of its long half-life, it is easy to accumulate in the circulation, causing an increase in PRL.

Experts have explained in detail the causes of hyperprolactinemia. This disease requires enhanced care in life. When caring for patients, family members should not make patients angry and try their best to make patients have a happy and positive attitude towards life. Family members can accompany patients to the suburbs to relax or travel every day to get rid of the troubles brought by the disease.