The Epidemiology of Hyperprolactinemia in A Single Tertiary Care Center: The Importance of Drug History and Role of An Endocrinologist

Abstract

Introduction: The underlying causes of hyperprolactinemia differ between studies. The study aimed to determine the causes, initial signs, and treatment methods of hyperprolactinemia. Materials and Methods: Prolactin (PRL) measurement was requested from 16241 patients between January 2016 and December 2019. A total of 176 patients whose serum prolactin levels above 29.9 ng/mL in two consecutive measurements were included in this study. Electronic Health Records (EHR) of these patients were reviewed. Results: Forty-Seven (26.8%) of 176 patients had a prolactinoma. Among the prolactinoma group, 63.8% of the patients had microadenoma. Polycystic Ovary Syndrome (PCOS)(29.5%), drugs (20.9%), and pituitary disorders other than prolactinoma (13.2%) were the most common causes of hyperprolactinemia in the non-prolactinoma group. Galactorrhea (38.3%) was the most common initial sign. Cabergoline's starting dose in the Endocrinology clinic was 1 mg/week, and 87.2% of the cases started with a 1 mg/week dose. All of the other cases (12.8%) who were diagnosed by other departments received inappropriate doses of cabergoline. Conclusions: Drug-induced hyperprolactinemia may be much more common than previously thought. Referring these patients to the Endocrinology clinic will be much more beneficial to determine both the correct dosage of cabergoline and the cause of hyperprolactinemia.