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Functional hyperprolactinemia and hypophyseal microadenoma in systemic sclerosis.

Olga Vera-Lastra1, Luis J Jara, Gabriela Medina

  • 1Department of Internal Medicine, Division of Research, Clinical and Epidemiology Research, Office of Education Research, Hospital de Espcialidades, Centro Medico La Raza, IMSS, Mexico City, Mexico.

The Journal of Rheumatology
|May 26, 2006
PubMed
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Systemic sclerosis patients frequently have hyperprolactinemia and pituitary microadenomas, indicating increased dopaminergic tone. Prolactin may play a role in systemic sclerosis development.

Area of Science:

  • Endocrinology
  • Rheumatology
  • Neuroendocrinology

Background:

  • Hyperprolactinemia (HPRL) is common in systemic sclerosis (SSc).
  • The link between HPRL, pituitary adenomas, and hypothalamic dopaminergic tone in SSc is not well understood.

Purpose of the Study:

  • To determine the prevalence of prolactin (PRL)-secreting pituitary adenomas in SSc patients.
  • To assess hypothalamic dopaminergic tone using the metoclopramide (MTC) test in SSc.

Main Methods:

  • 30 SSc patients and 20 controls underwent serum PRL measurement via radioimmunoassay.
  • Dynamic testing with MTC (10 mg) assessed PRL response at 30, 60, 90, and 120 minutes.
  • Computed tomography (CT) of the sella turcica was performed to detect pituitary adenomas.

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Main Results:

  • SSc patients exhibited significantly higher PRL levels post-MTC stimulation compared to controls (p < 0.001 at 30 min).
  • CT scans revealed microadenomas in 24/30 SSc patients versus 1/20 controls (p = 0.001).
  • Basal PRL levels did not significantly differ between groups.

Conclusions:

  • A high prevalence of HPRL with increased central dopaminergic tone and microadenomas exists in SSc.
  • PRL may contribute to the pathogenesis of SSc.
  • Further research is needed to validate these findings.