Elevated Prolactin Concentrations Research Articles

Hyperprolactinemia in sarcoidosis.

Serum prolactin levels were measured in 34 patients with extrapulmonary sarcoidosis (10 men, 24 women). Four patients had the syndrome of galactorrhea and amenorrhea. Eleven patients (3 men, 8 women) had elevated serum prolactin levels, with values ranging between 5 and 100 ng/ml. Serum prolactin levels in age-matched healthy controls and in patients with tuberculosis were less than 2 ng/ml in all cases. In three of the four patients with the galactorrhea-amenorrhea syndrome, treatment with L-dopa suppressed prolactin secretion, with cessation of galactorrhea and increased gonadotropin secretion with resumption of menses. A subsequent autopsy examination of 1 male patient with hyperprolactinemia showed sarcoid granulomata in hypothalamic nuclei, bilaterally. In six of these patients the elevated serum prolactin concentration was the only endocrine abnormality detected. These studies suggest that sarcoid granulomata may selectively destroy specific hypothalamic nuclei that normally inhibit the secretion of prolactin by the anterior pituitary. Measurement of the serum prolactin concentration may serve as a sensitive test for the detection of hypothalamic involvement in some patients with sarcoidosis.