Kilci Fatih, Sarikaya Emre, Murat Nurhan Özcan, Deniz Adnan
Department of Pediatric Endocrinology, Kocaeli City Hospital, Kocaeli, Turkey.
Department of Pediatric Neurology, Kocaeli City Hospital, Kocaeli, Turkey.
Endocrine. 2025 May;88(2):553-563. doi: 10.1007/s12020-025-04176-0. Epub 2025 Feb 2.
Hyperprolactinemia in children and adolescents can result from various etiologies, including pituitary masses. Understanding the underlying causes, clinical presentation, and outcomes is essential for effective management.
A retrospective cohort study was conducted, analyzing clinical data from patients diagnosed with hyperprolactinemia secondary to pituitary masses. The study included patients aged under 18 years, who were diagnosed between January 2018 and September 2024. Patients were classified into two groups: those with prolactinoma and those with non-prolactinoma causes, including non-functioning pituitary adenomas (NFPAs) and craniopharyngiomas. Serum prolactin levels, imaging studies, and treatment responses were assessed.
A total of 33 patients with hyperprolactinemia attributed to pituitary masses were identified. The diagnoses among the patients were as follows: 54.5% had prolactinomas, 24.2% had NFPAs, and 21.2% had craniopharyngiomas. The age at diagnosis ranged from 8.4-17.9 years. In the prolactinoma group, the mean age at diagnosis was 15.6 ± 2.1 years, while in the non-prolactinoma group, it was 13.5 ± 2.9 years, and a statistically significant difference was observed (p = 0.024). The median prolactin level was 258 ng/mL (range: 30.5-14,35 0 ng/mL). According to the diagnoses, the median prolactin level was 491.5 ng/mL (range: 249-14,350 ng/mL) for prolactinomas, 45.6 ng/mL (range: 30.5-68.5 ng/mL) for NFPAs, and 61 ng/mL (range: 44-72 ng/mL) for craniopharyngiomas. Menstrual irregularities, headaches, and galactorrhea were the most commonly reported complaints. Overweight/obesity was present in 39.3% of the entire cohort, while patients with prolactinomas demonstrated a significant reduction in BMI SDS following cabergoline treatment. Cabergoline treatment achieved a 100% success rate in patients with prolactinomas.
We observed a higher prevalence of hyperprolactinemia due to NFPAs and craniopharyngiomas compared to previous reports. Notably, obesity was prevalent among patients and demonstrated a favorable response to cabergoline therapy. These findings emphasize the necessity for future studies, particularly larger prospective trials incorporating genetic analyses, to enhance our understanding of the characteristics and treatment outcomes of pediatric hyperprolactinemia.
儿童和青少年高泌乳素血症可由多种病因引起，包括垂体肿块。了解其潜在病因、临床表现和治疗结果对于有效管理至关重要。
进行了一项回顾性队列研究，分析诊断为垂体肿块继发高泌乳素血症患者的临床资料。该研究纳入了2018年1月至2024年9月期间诊断的18岁以下患者。患者分为两组：泌乳素瘤患者和非泌乳素瘤病因患者，后者包括无功能垂体腺瘤（NFPA）和颅咽管瘤。评估血清泌乳素水平、影像学检查和治疗反应。
共确定了33例因垂体肿块导致高泌乳素血症的患者。患者的诊断如下：54.5%为泌乳素瘤，24.2%为NFPA，21.2%为颅咽管瘤。诊断时的年龄范围为8.4 - 17.9岁。在泌乳素瘤组中，诊断时的平均年龄为15.6±2.1岁，而非泌乳素瘤组为13.5±2.9岁，差异有统计学意义（p = 0.024）。泌乳素中位数水平为258 ng/mL（范围：30.5 - 14350 ng/mL）。根据诊断，泌乳素瘤的泌乳素中位数水平为491.5 ng/mL（范围：249 - 14350 ng/mL），NFPA为45.6 ng/mL（范围：30.5 - 68.5 ng/mL），颅咽管瘤为61 ng/mL（范围：44 - 72 ng/mL）。月经不调、头痛和溢乳是最常报告的症状。整个队列中39.3%存在超重/肥胖，而泌乳素瘤患者在接受卡麦角林治疗后BMI SDS显著降低。卡麦角林治疗对泌乳素瘤患者的成功率达100%。
与既往报告相比，我们观察到NFPA和颅咽管瘤导致的高泌乳素血症患病率更高。值得注意的是，肥胖在患者中普遍存在，且对卡麦角林治疗反应良好。这些发现强调了未来研究的必要性，特别是纳入基因分析的更大规模前瞻性试验，以加深我们对儿童高泌乳素血症特征和治疗结果的理解。
