Olive K E, Hennessey J V
Department of Medicine, US Air Force Medical Center, Wright-Patterson Air Force Base, Ohio.
Arch Intern Med. 1988 Oct;148(10):2278-9.
Hyperprolactinemia is common in primary hypothyroidism but, to our knowledge, marked elevation of serum prolactin in subclinical hypothyroidism has not been previously reported. A 45-year-old woman presenting with carpal tunnel syndrome was found to have a minimally elevated level of thyrotropin with a normal level of thyroxine. Thyrotropin releasing hormone stimulation testing revealed hyperresponsiveness consistent with primary hypothyroidism. An unstimulated prolactin level was 187 micrograms/L and returned to normal with levothyroxine therapy. Results of visual field testing were normal, and a computed tomographic scan of the pituitary gland revealed no evidence of a macroadenoma. This case demonstrates the occurrence of significant hyperprolactinemia in the absence of overt primary hypothyroidism.
高催乳素血症在原发性甲状腺功能减退症中很常见，但据我们所知，亚临床甲状腺功能减退症患者血清催乳素显著升高此前尚未见报道。一名因腕管综合征就诊的45岁女性，促甲状腺激素水平轻度升高，甲状腺素水平正常。促甲状腺激素释放激素刺激试验显示反应过度，符合原发性甲状腺功能减退症。未刺激状态下催乳素水平为187微克/升，左甲状腺素治疗后恢复正常。视野测试结果正常，垂体计算机断层扫描未发现大腺瘤证据。该病例表明，在无明显原发性甲状腺功能减退症的情况下可发生显著的高催乳素血症。
