Endocrine Abstracts

JOINT3566

Introduction: Prolactin-secreting pituitary adenomas (prolactinoma) are generally benign tumors that appear following the monoclonal expansion of a cell line of the anterior pituitary (lactotropic cells). Prolactin (Prl) is a polypeptide hormone, primarily regulated by the inhibitory control of dopamine. This suppression has been proposed as a potential mechanism responsible for weight gain and metabolic abnormalities in patients. Elevated prolactin may promote obesity by disrupting lipid metabolism and influencing appetite. Prolactinomas are classified based on their size into microprolactinomas (<10 mm largest diameter) and macroprolactinomas (≥10 mm largest diameter) Treatment is primarily based on dopamine agonists, particularly cabergoline.

Case report: A 9 years old patient, diagnosed with a giant macroprolactinoma, who underwent surgery and experienced post-operative corticotropic deficiency, for which replacement therapy was started at a dose of 10 mg per day. The patient’s progression was marked by significant weight gain associated with polyphagia, and the case is being closely monitored as part of our clinical care protocol On clinical examination, the patient had a BMI of 30 kg/m² and a waist circumference of 95 cm, which were indicative of pathological obesity.

Discussion: Hyperprolactinemia induces a functional blockade of dopaminergic tone, which may contribute to hyperphagia and weight gain observed in patients, thus playing a role in the pathogenesis of obesity, as demonstrated in our patient Expression of the Prl receptor (Prl-R) gene has previously been described in adipose tissue, and an increase in this expression during lactation has been documented in rats and humans. the study by Haji H et al demonstrated in Prl-R-deficient mice a reduction in abdominal fat and leptin concentration compared to controls. Studies have clearly shown that dopamine agonists significantly improve glucose homeostasis and insulin resistance and reduce body weight.

Conclusion: Hyperprolactinemia (HPL) promotes metabolic alterations, and controlling excess prolactin with dopamine agonists is essential for inducing weight loss and improving the metabolic profile.