Hyperprolactinemia, infertility, and hypothyroidism. A case report and literature review

A 30-year-old woman presented with infertility, hyperprolactinemia, and pituitary enlargement. Although relatively asymptomatic, she was found to have primary hypothyroidism. She became pregnant within a month following institution of levothyroxine replacement, and the pituitary enlargement resolved within one year. We discuss the relationship between hypothyroidism, hyperprolactinemia, and pituitary enlargement. This case emphasizes the need for thyroidal status evaluation in patients with presumptive prolactin-producing pituitary tumors before initiation of therapy for the hyperprolactinemia.