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Prolactin dynamics in a patient with isolated ACTH deficiency accompanied by hyperprolactinemia
1Department of Internal Medicine, Kouritsu Yanase Hospital, Hyogo, Japan.
The American Journal of the Medical Sciences
|February 1, 1988
Summary
Isolated ACTH deficiency can cause hyperprolactinemia. Glucocorticoid replacement therapy normalized prolactin levels and responsiveness, suggesting deficiency caused these hormonal changes.
Area of Science:
- Endocrinology
- Neuroendocrinology
Background:
- Isolated ACTH deficiency is a rare condition.
- Hyperprolactinemia can be associated with various endocrine disorders.
Observation:
- A case of isolated ACTH deficiency with concurrent hyperprolactinemia was investigated.
- Prolactin (PRL) secretory dynamics were assessed using TRH, sulpiride, and L-dopa tests before and after glucocorticoid replacement.
Findings:
- Before glucocorticoid therapy, patients exhibited PRL hyper-responsiveness to TRH and sulpiride, with sulpiride causing a greater increase.
- L-dopa effectively suppressed PRL levels.
- Following glucocorticoid replacement, basal PRL normalized, and hyper-responsiveness to TRH and sulpiride resolved.
Implications:
- These findings indicate that glucocorticoid deficiency may be the cause of elevated basal PRL and hyper-responsiveness in this patient.
- This highlights the intricate relationship between the hypothalamic-pituitary-adrenal axis and prolactin regulation.