Grubb M R, Chakeres D, Malarkey W B
Department of Internal Medicine, Ohio State University, Columbus.
Am J Med. 1987 Oct;83(4):765-9. doi: 10.1016/0002-9343(87)90911-9.
Hyperprolactinemia can occur in patients with primary hypothyroidism. Two women with hypothyroidism who had elevated serum prolactin levels, galactorrhea, amenorrhea, and pituitary computed tomographic scans that demonstrated the presence of "pituitary tumors" were recently evaluated. It was believed that they had prolactinomas, and they were referred for possible surgery. An elevated serum thyroid-stimulating hormone level, however, suggested that they had primary hypothyroidism and probably pituitary enlargement secondary to pituitary hyperplasia. Detailed evaluation of thyroid-stimulating hormone and prolactin secretion was performed. These studies revealed several abnormalities in dopamine-prolactin interactions; however, the primary event responsible for the hyperprolactinemia is unclear. These women were given thyroxine therapy, and subsequent radiologic and endocrine studies documented resolution of their "pseudotumors" and normalization of the serum thyroxine and prolactin levels. Hence, thyroid-stimulating hormone levels should be measured in all patients presenting with a suspected prolactinoma so that any hypothyroidism that is noted is not presumed to be due to secondary hypothyroidism from tumor involvement of the pituitary.
高催乳素血症可发生于原发性甲状腺功能减退症患者。最近对两名患有甲状腺功能减退症的女性进行了评估，她们血清催乳素水平升高，有溢乳、闭经症状，垂体计算机断层扫描显示存在“垂体瘤”。人们认为她们患有催乳素瘤，并因此被转诊考虑可能进行手术。然而，血清促甲状腺激素水平升高提示她们患有原发性甲状腺功能减退症，垂体增大可能是继发于垂体增生。对促甲状腺激素和催乳素分泌进行了详细评估。这些研究揭示了多巴胺 - 催乳素相互作用存在一些异常；然而，导致高催乳素血症的主要原因尚不清楚。给予这些女性甲状腺素治疗，随后的影像学和内分泌学研究表明她们的“假瘤”消退，血清甲状腺素和催乳素水平恢复正常。因此，对于所有疑似患有催乳素瘤的患者都应检测促甲状腺激素水平，以便任何已发现的甲状腺功能减退症不会被假定为是由于垂体肿瘤累及导致的继发性甲状腺功能减退症。
