CLINICAL CASE OF HYPERPROLACTINEMIA, COMBINED WITH HIGH TSH LEVEL
DOI:
https://doi.org/10.11603/bmbr.2706-6290.2019.2.10665Keywords:
hyperprolactionemia, thyroid stimulating hormone, L-thyroxineAbstract
Results and Discussion. Hyperprolactinemia is a permanent increased prolactin level in the blood plasma. It occurs in the form of physiological and pathological forms in women and men which frequency is near 17 cases per 100000 inhabitants. Hyperprolactinemia may be caused by pituitary tumors, primary hypothyroidism, chronic renal failure, liver cirrhosis, polycystic ovary syndrome and usage of some medications. Frequency of idiopathic hyperprolactinemia is near 30–40 %. Combination of hyperprolactinemia with high concentration of thyroid stimulating hormone results in a necessity to differentiate mixed pituitary adenoma and hyperprolactinemia that is a symptom of hypothyroidism. The article presents clinical case of hyperprolactinemia, combined with high level of thyroid stimulating hormone in the blood. Patient complained with general weakness fatigue and frequent headache due to intensity of school studying. Increased levels of TSH, prolactin and free thyroxine in the blood were diagnosed. Concentration of growth hormone, luteinizing, follicle-stimulating hormones and cortisol in the blood were normal. Locus with sizes 4×3 mm (possibly adenoma) was found in the left part of the adenohypophysis. Case follow-up period included measurement of prolactin, TSH and free thyroxin in the blood and pituitary magnetic resonance. Treatment scheme was administered that included cabergoline, medication with dry extract of chaste tree fruits and L-thyroxine that let to achieve normoprolactinaemia without decreasing of prolactin concentration below normal and keep TSH concentration up in normal range without causing symptoms of L-thyroxine overdose.
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