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Increased serum prolactin but normal TSH during prolonged domperidone treatment in children
Insights
Domperidone, a dopamine receptor blocker, significantly increased prolactin levels in infants treated for gastroesophageal reflux. High doses may cause reversible breast enlargement and milk production, without affecting thyroid-stimulating hormone (TSH).
Area of Science:
- Pediatric Endocrinology
- Pharmacology
Background:
- Gastroesophageal reflux is common in infants.
- Domperidone is a dopamine receptor antagonist used to treat gastrointestinal motility disorders.
Purpose of the Study:
- To investigate the effects of domperidone on prolactin and TSH secretion in infants.
- To assess the relationship between domperidone dosage and prolactin levels.
- To evaluate the incidence of side effects like breast hypertrophy and galactorrhea.
Main Methods:
- Study included 16 infants (10-360 days old) treated for gastroesophageal reflux.
- Serum prolactin and TSH levels were measured before and during domperidone treatment.
- Plasma domperidone levels were correlated with prolactin levels.
Main Results:
- Domperidone significantly increased prolactin levels on days 1, 4, and 21-28 of treatment.
- No correlation was found between serum prolactin and plasma domperidone levels.
- Four infants developed reversible breast hypertrophy with galactorrhea, associated with high domperidone doses.
- Thyroid-stimulating hormone (TSH) secretion was not affected in 13 patients.
Conclusions:
- Domperidone effectively increases prolactin levels in infants.
- High-dose domperidone may lead to dose-dependent side effects like breast hypertrophy and galactorrhea.
- Domperidone does not appear to influence TSH secretion in infants.
Abstract:
The influence of the dopamine receptor blocking agent domperidone on prolactin and TSH secretion was studied in 16 infants, aged 10-360 days, who were treated for gastroesophageal reflux. The pretreatment serum prolactin levels were not statistically different from the levels in age-matched controls and showed the well-known inverse relationship with age. During treatment with domperidone a significant increase in prolactin level was observed on days 1, 4 and 21-28, the mean values on these three days not being statistically different. No correlation could be found between the serum prolactin levels and the corresponding plasma domperidone levels. One infant of this series and three not included in this series developed reversible breast hypertrophy with galactorrhoea in three of them: in none of them was the prolactin level, corrected for age, above 1 SD of the mean. All had received relatively high doses of domperidone. In 13 patients domperidone did not influence TSH secretion.