Hyperprolactinaemia is the most common disturbance in the pituitary gland function. Different physiological and patological conditions could influnce prolactin (PRL) secretion. Prolactin secreting tumors (micro and macroprolactinomas) are rare in children and adolescents (estimated incidence is 1 per milion). Functional diversity of prolactin action is responsable for different initial clinical expression of hyperprolactinaemia.
We investigated causes of hyperprolactinaemia in 11 children and adolescents (6 females and 5 males), aged from 1.5 to 17.5 years with different clinical expression at admission. Children with primary hypothyroidism, jatrogenic hyperprolactinamia and PCOs adolescents were excluded. Four patients had short stature or growth deceleration, the same number was clinicaly obese, two adolescent girls had secondary amenorrhoea, two girls had premature thelarche and gynaecomastia and hypogonadism were indication for endocrinologic examination of two adolescent boys. Vasculitis and obesity and recidivant herpes viral infections and obesity were present in two school children. Hyperprolactinaemia was found also in the youngest girl with multiple ovarial cysts.
We documented very high PRL level in PRL profile in all patients (mean 2100 mU/l). MRI of pituitary was indicated and revealed 4 microprolactinomas, 1 congenital hypophyseal cyst and 1 tumor of the hypothalamus.
Children with hyperprolactinaemia expressed a wide variety of initial clinical presentations. The most common were growth and puberty disorders and obesity. PRL determination should be included in investigation protocols of obese and short children as prolactinoma, although rare, is nevertheless a likely disease, even in childhood.
03 - 07 May 2008
European Society of Endocrinology