Cordiano Vincenzo
Ann Hematol. 2005 Mar;84(3):200-2. doi: 10.1007/s00277-004-0973-5. Epub 2004 Dec 14.
A 44-year-old woman who had been suffering for 10 years from amenorrhea and hyperprolactinemia resistant to high doses of bromocriptine was hospitalized with erythrocytosis, normal serum erythropoietin (sEpo) levels, and hypertension. Erythrocytosis secondary to uterine myoma and a prolactin-secreting pituitary microadenoma were initially diagnosed. The hyperprolactinemia was bromocriptine resistant, despite gradual increase of the dosage to 30 mg/day. Both hyperprolactinemia and erythrocytosis unexpectedly regressed completely after the patient underwent hysterectomy for a uterine fibroid 9 months after the erythrocytosis was first disclosed. Given the well-known effects of prolactin on hematopoietic cells, we hypothesize that--in this very unusual case--the two main, apparently unrelated abnormalities (erythrocytosis with normal sEpo levels and hyperprolactinemia) may have been the clinical consequence of the functional redundancy and pleiotropy of the "pituitary" hormone prolactin, inappropriately secreted by a uterine fibroid for more than 10 years.
一名44岁女性，闭经和高泌乳素血症10年，对高剂量溴隐亭耐药，因红细胞增多症、血清促红细胞生成素（sEpo）水平正常及高血压入院。最初诊断为子宫肌瘤继发红细胞增多症和分泌泌乳素的垂体微腺瘤。尽管溴隐亭剂量逐渐增加至30mg/天，但高泌乳素血症仍对其耐药。在红细胞增多症首次发现9个月后，患者因子宫肌瘤接受子宫切除术后，高泌乳素血症和红细胞增多症均意外完全消退。鉴于泌乳素对造血细胞的已知作用，我们推测——在这个非常特殊的病例中——这两个主要的、明显不相关的异常情况（sEpo水平正常的红细胞增多症和高泌乳素血症）可能是子宫肌瘤分泌超过10年的“垂体”激素泌乳素功能冗余和多效性的临床后果。
