Soares Leaes Carolina Garcia, Pereira-Lima Júlia Fernanda Semmelmann, da Costa Oliveira Miriam
Neuroendocrinology Center of Santa Casa de Porto Alegre, UFCSPA, Brazil.
Neuro Endocrinol Lett. 2011;32(5):616-8.
Several drugs may cause hyperprolactinemia, especially antipsychotic drugs and prokynetic drugs. Serum prolactin concentrations increase within hours after acute administration of these drugs and return to normal within two to four days after cessation of chronic therapy. So far, sibutramine, a sympathomimetic drug used in the management of obesity, was not described to be associated with altered prolactin levels.
The purpose of this study is to present a case of sibutramine-induced hiperprolactinemia.
A 38-year-old white female patient seeks medical attention complaining of weight gain (Body mass index: 35) associated with anxiety. She started sibutramine treatment and presented with amenogalactorrhea. Hyperprolactinemia was diagnosed (prolactin of 46 and 89.6 ng/mL) with normal thyroid, renal and hepatic function, and a negative pregnancy test. A sella MRI was performed and sibutramine was suspended. Prolactin levels returned to normal within 15 days of sibutramine cessation and remained normal within 90 days of follow-up, with resolution of the amenogalactorrhea syndrome.
sibutramine may be considered in differential diagnosis of drug-induced hyperprolactinemia.
几种药物可能导致高泌乳素血症，尤其是抗精神病药物和促动力药物。急性服用这些药物后数小时内血清泌乳素浓度会升高，慢性治疗停止后两到四天内会恢复正常。到目前为止，尚未有报道称用于治疗肥胖症的拟交感神经药物西布曲明与泌乳素水平改变有关。
本研究旨在报告一例西布曲明所致高泌乳素血症病例。
一名38岁白人女性患者因体重增加（体重指数：35）伴焦虑前来就医。她开始服用西布曲明治疗后出现闭经溢乳。诊断为高泌乳素血症（泌乳素水平分别为46和89.6纳克/毫升），甲状腺、肾脏和肝脏功能正常，妊娠试验阴性。进行了蝶鞍区磁共振成像检查，并停用了西布曲明。停用西布曲明后15天内泌乳素水平恢复正常，随访90天内一直保持正常，闭经溢乳综合征也得到缓解。
在药物性高泌乳素血症的鉴别诊断中可考虑西布曲明。
