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Hyperprolactinemia in portal systemic encephalopathy

C J McClain, J P Kromhout, M K Elson

    Digestive Diseases and Sciences
    |April 1, 1981
    PubMed
    Summary
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    Altered neurotransmitter function, indicated by high prolactin levels, is linked to portal systemic encephalopathy (PSE) in alcoholic liver disease. Markedly elevated prolactin signals a poor prognosis for PSE patients.

    Area of Science:

    • Neuroscience
    • Hepatology
    • Endocrinology

    Background:

    • Portal systemic encephalopathy (PSE) is associated with altered neurotransmitter function.
    • False neurotransmitters like octopamine may accumulate, while dopamine depletes in PSE.
    • Dopamine activity is difficult to measure directly in patients.

    Purpose of the Study:

    • To evaluate dopaminergic function in patients with alcoholic liver disease and PSE.
    • To assess the relationship between prolactin levels and PSE severity and prognosis.
    • To explore the pathophysiological significance of altered dopamine function in chronic liver disease.

    Main Methods:

    • Measured plasma prolactin levels in 21 patients with alcoholic liver disease and PSE.
    • Compared prolactin levels to several control groups.

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  • Correlated prolactin levels with clinical and biochemical markers of liver function and mortality.

    • Main Results:

    • Patients with PSE exhibited significantly elevated plasma prolactin levels compared to controls.
    • PSE patients with markedly elevated prolactin showed greater biochemical derangements and 100% mortality.
    • Elevated prolactin levels correlated with poorer outcomes in PSE patients.

    Conclusions:

    • Altered neurotransmitter function, specifically dopaminergic activity, is implicated in PSE.
    • Plasma prolactin is a sensitive indicator of dopaminergic dysfunction in chronic liver disease.
    • Markedly elevated prolactin in PSE indicates an ominous prognosis and may aid in treatment selection.