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Longstanding hyperprolactinemia associated with systemic lupus erythematosus: possible hormonal stimulation of an
R W McMurray1, S H Allen, A L Braun
1Division of Immunology and Rheumatology, University of Missouri-Columbia 65212.
Objective:
To describe 4 women in whom hyperprolactinemia was associated with the development of systemic lupus erythematosus (SLE).
Methods:
Clinical assessment and followup (2 cases). Chart review and interviews with the attending rheumatologist (2 cases). Detailed review and reassessment of multiple imaging studies of the pituitary.
Results:
One patient had idiopathic hyperprolactinemia, and 3 had pituitary microadenomas. Serum 17 beta-estradiol concentrations were normal in all women, but serum testosterone was suppressed in 2. SLE flares occurred in 2 individuals, one and 6 months after bromocriptine therapy was discontinued, and reinstitution of bromocriptine therapy in a patient who refused corticosteroids resulted in resolution of her SLE disease activity.
Conclusion:
Hyperprolactinemia, which has the potential to exacerbate autoimmunity, may coexist with SLE. In these instances, bromocriptine may afford therapeutic benefit.