Hyperprolactinaemia and pituitary adenomas in adolescence

Six adolescents, five males with prolactin-secreting pituitary macroadenomas and one female with idiopathic hyperprolactinaemia, are described. Their ages at presentation ranged from 13 years 7 months to 16 years 6 months. Presenting symptoms included headache, visual field defect, arrested growth and puberty. Only two cases had galactorrhoea. Every case had an elevated serum prolactin level. Three had surgery before the results of serum prolactin were to hand. Each patient was treated with bromocriptine. Bromocriptine suppressed serum prolactin level to normal in four cases, but in the girl with idiopathic hyperprolactinaemia, bromocriptine was not useful. In two boys, serum prolactin was not suppressed with bromocriptine therapy alone, and they were subsequently treated with cabergoline, surgery and irradiation. Nevertheless, in children and adolescents with prolactin-secreting pituitary adenoma, bromocriptine should be the first line of treatment.