eMedicine Specialties > Endocrinology > Pituitary Gland

Prolactin Deficiency: Follow-up

Author: Charles T Benson, MD, PhD, Medical Advisor, Eli Lilly and Company, UK
Contributor Information and Disclosures

Updated: Aug 5, 2008

Follow-up

Further Inpatient Care

  • Typically, prolactin deficiency is not managed in the hospital setting.

Patient Education

  • If hypoprolactinemia is established, educate the patient about the reality of not being able to breast-feed her baby.
  • For excellent patient education resources, visit eMedicine's Women's Health Center. Also, see eMedicine's patient education article Breastfeeding.

Miscellaneous

Medicolegal Pitfalls

  • Failure to diagnose prolactin deficiency
 


More on Prolactin Deficiency

Overview: Prolactin Deficiency
Differential Diagnoses & Workup: Prolactin Deficiency
Treatment & Medication: Prolactin Deficiency
Follow-up: Prolactin Deficiency
References
Further Reading
[ CLOSE WINDOW ]

References

  1. Cosman F, Post KD, Holub DA, et al. Lymphocytic hypophysitis. Report of 3 new cases and review of the literature. Medicine (Baltimore). Jul 1989;68(4):240-56. [Medline].

  2. Thodou E, Asa SL, Kontogeorgos G, et al. Clinical case seminar: lymphocytic hypophysitis: clinicopathological findings. J Clin Endocrinol Metab. Aug 1995;80(8):2302-11. [Medline]. [Full Text].

  3. Toledano Y, Lubetsky A, Shimon I. Acquired prolactin deficiency in patients with disorders of the hypothalamic-pituitary axis. J Endocrinol Invest. Apr 2007;30(4):268-73. [Medline].

  4. Zargar AH, Masoodi SR, Laway BA, et al. Familial puerperal alactogenesis: possibility of a genetically transmitted isolated prolactin deficiency. Br J Obstet Gynaecol. May 1997;104(5):629-31. [Medline].

  5. Falk RJ. Isolated prolactin deficiency: a case report. Fertil Steril. Nov 1992;58(5):1060-2. [Medline].

  6. Kauppila A, Chatelain P, Kirkinen P, et al. Isolated prolactin deficiency in a woman with puerperal alactogenesis. J Clin Endocrinol Metab. Feb 1987;64(2):309-12. [Medline].

  7. Swaminathan G, Varghese B, Thangavel C, et al. Prolactin stimulates ubiquitination, initial internalization, and degradation of its receptor via catalytic activation of Janus kinase 2. J Endocrinol. Feb 2008;196(2):R1-7. [Medline].

  8. Oseko F, Nakano A, Morikawa K, et al. Effects of chronic bromocriptine-induced hypoprolactinemia on plasma testosterone responses to human chorionic gonadotropin stimulation in normal men. Fertil Steril. Feb 1991;55(2):355-7. [Medline].

  9. Russell DH, Kibler R, Matrisian L, et al. Prolactin receptors on human T and B lymphocytes: antagonism of prolactin binding by cyclosporine. J Immunol. May 1985;134(5):3027-31. [Medline].

  10. Bernton EW, Meltzer MS, Holaday JW. Suppression of macrophage activation and T-lymphocyte function in hypoprolactinemic mice. Science. Jan 22 1988;239(4838):401-4. [Medline].

  11. Carrier M, Wild J, Pelletier LC, et al. Bromocriptine as an adjuvant to cyclosporine immunosuppression after heart transplantation. Ann Thorac Surg. Jan 1990;49(1):129-32. [Medline].

  12. Palestine AG, Nussenblatt RB, Gelato M. Therapy for human autoimmune uveitis with low-dose cyclosporine plus bromocriptine. Transplant Proc. Jun 1988;20(3 Suppl 4):131-5. [Medline].

  13. Lucas A, Baker BA, Cole TJ. Plasma prolactin and clinical outcome in preterm infants. Arch Dis Child. Sep 1990;65(9):977-83. [Medline]. [Full Text].

  14. Bonomo IT, Lisboa PC, Pereira AR, et al. Prolactin inhibition in dams during lactation programs for overweight and leptin resistance in adult offspring. J Endocrinol. Feb 2007;192(2):339-44. [Medline].

  15. Fofanova O, Takamura N, Kinoshita E, et al. Compound heterozygous deletion of the PROP-1 gene in children with combined pituitary hormone deficiency. J Clin Endocrinol Metab. Jul 1998;83(7):2601-4. [Medline]. [Full Text].

  16. Rosenbloom AL, Almonte AS, Brown MR, et al. Clinical and biochemical phenotype of familial anterior hypopituitarism from mutation of the PROP1 gene. J Clin Endocrinol Metab. Jan 1999;84(1):50-7. [Medline]. [Full Text].

  17. Yang H, Dixit VD, Patel K, et al. Reduction in hypophyseal growth hormone and prolactin expression due to deficiency in ghrelin receptor signaling is associated with Pit-1 suppression: relevance to the immune system. Brain Behav Immun. Jun 17 2008;[Medline].

  18. Samuels MH, Henry P, Kleinschmidt-Demasters B, et al. Pulsatile prolactin secretion in hyperprolactinemia due to presumed pituitary stalk interruption. J Clin Endocrinol Metab. Dec 1991;73(6):1289-93. [Medline].

  19. Diaz S, Seron-Ferre M, Cardenas H, et al. Circadian variation of basal plasma prolactin, prolactin response to suckling, and length of amenorrhea in nursing women. J Clin Endocrinol Metab. May 1989;68(5):946-55. [Medline].

  20. Stawerska R, Lewinski A, Smyczynska J, et al. Circadian pattern of prolactin secretion in children with growth hormone deficiency and congenital organic lesions in the hypothalamic-pituitary region. Neuro Endocrinol Lett. Dec 2007;28(6):765-74. [Medline].

  21. Ehrenkranz RA, Ackerman BA. Metoclopramide effect on faltering milk production by mothers of premature infants. Pediatrics. Oct 1986;78(4):614-20. [Medline].

  22. Gupta AP, Gupta PK. Metoclopramide as a lactogogue. Clin Pediatr (Phila). May 1985;24(5):269-72. [Medline].

  23. Kauppila A, Anunti P, Kivinen S, et al. Metoclopramide and breast feeding: efficacy and anterior pituitary responses of the mother and the child. Eur J Obstet Gynecol Reprod Biol. Jan 1985;19(1):19-22. [Medline].

  24. Kauppila A, Kivinen S, Ylikorkala O. A dose response relation between improved lactation and metoclopramide. Lancet. May 30 1981;1(8231):1175-7. [Medline].

  25. Kauppila A, Kivinen S, Ylikorkala O. Metoclopramide increases prolactin release and milk secretion in puerperium without stimulating the secretion of thyrotropin and thyroid hormones. J Clin Endocrinol Metab. Mar 1981;52(3):436-9. [Medline].

  26. Sousa PL. Letter: Metoclopramide and breast-feeding. Br Med J. Mar 1 1975;1(5956):512. [Medline]. [Full Text].

  27. Andersen AN, Lund-Andersen C, Larsen JF, et al. Suppressed prolactin but normal neurophysin levels in cigarette smoking breast-feeding women. Clin Endocrinol (Oxf). Oct 1982;17(4):363-8. [Medline].

  28. Carlson HE, Brickman AS, Bottazzo GF. Prolactin deficiency in pseudohypoparathyroidism. N Engl J Med. Jan 20 1977;296(3):140-4. [Medline].

  29. Clevenger CV, Altmann SW, Prystowsky MB. Requirement of nuclear prolactin for interleukin-2--stimulated proliferation of T lymphocytes. Science. Jul 5 1991;253(5015):77-9. [Medline].

  30. Devins SS, Miller A, Herndon BL, et al. Effects of dopamine on T-lymphocyte proliferative responses and serum prolactin concentrations in critically ill patients. Crit Care Med. Dec 1992;20(12):1644-9. [Medline].

  31. Doty RL, Fernandez AD, Levine MA, et al. Olfactory dysfunction in type I pseudohypoparathyroidism: dissociation from Gs alpha protein deficiency. J Clin Endocrinol Metab. Jan 1997;82(1):247-50. [Medline]. [Full Text].

  32. Du Ruisseau P, Taché Y, Brazeau P, et al. Effects of chronic immobilization stress on pituitary hormone secretion, on hypothalamic factor levels, and on pituitary responsiveness to LHRH and TRH in female rats. Neuroendocrinology. 1979;29(2):90-9. [Medline].

  33. Gonzales GF, Velasquez G, Garcia-Hjarles M. Hypoprolactinemia as related to seminal quality and serum testosterone. Arch Androl. 1989;23(3):259-65. [Medline].

  34. Hypoprolactinaemia. Lancet. Jun 13 1987;1(8546):1356-7. [Medline].

  35. Kauppila A. Isolated prolactin deficiency. Curr Ther Endocrinol Metab. 1997;6:31-3. [Medline].

  36. Lopez-Calderon A, Ariznavarreta C, Calderon MD, et al. Role of the adrenal cortex in chronic stress-induced inhibition of prolactin secretion in male rats. J Endocrinol. Feb 1989;120(2):269-73. [Medline].

  37. Murphy WJ, Rui H, Longo DL. Effects of growth hormone and prolactin immune development and function. Life Sci. 1995;57(1):1-14. [Medline].

  38. Oda T, Yoshimura Y, Takehara Y, et al. Effects of prolactin on fertilization and cleavage of human oocytes. Horm Res. 1991;35 Suppl 1:33-8. [Medline].

  39. Ozbey N, Inanc S, Aral F, et al. Clinical and laboratory evaluation of 40 patients with Sheehan's syndrome. Isr J Med Sci. Nov 1994;30(11):826-9. [Medline].

  40. Parks JS, Abdul-Latif H, Kinoshita E, et al. Genetics of growth hormone gene expression. Horm Res. 1993;40(1-3):54-61. [Medline].

  41. Peters F, Schulze-Tollert J, Schuth W. Thyrotrophin-releasing hormone--a lactation-promoting agent?. Br J Obstet Gynaecol. Sep 1991;98(9):880-5. [Medline].

  42. Poindexter AN, Buttram VC, Besch PK, et al. Circulating prolactin levels. I. Normal females. Int J Fertil. 1977;22(1):1-5. [Medline].

  43. Pullano JG, Cohen-Addad N, Apuzzio JJ, et al. Water and salt conservation in the human fetus and newborn. I. Evidence for a role of fetal prolactin. J Clin Endocrinol Metab. Dec 1989;69(6):1180-6. [Medline].

  44. Rigg LA, Lein A, Yen SS. Pattern of increase in circulating prolactin levels during human gestation. Am J Obstet Gynecol. Oct 15 1977;129(4):454-6. [Medline].

  45. Russell DH. New aspects of prolactin and immunity: a lymphocyte-derived prolactin-like product and nuclear protein kinase C activation. Trends Pharmacol Sci. Jan 1989;10(1):40-4. [Medline].

  46. Russell DH, Larson DF, Cardon SB, et al. Cyclosporine inhibits prolactin induction of ornithine decarboxylase in rat tissues. Mol Cell Endocrinol. May 1984;35(2-3):159-66. [Medline].

  47. Seibel MM, Smith D, Dlugi AM, et al. Periovulatory follicular fluid hormone levels in spontaneous human cycles. J Clin Endocrinol Metab. Jun 1989;68(6):1073-7. [Medline].

  48. Sheehan HL. The recognition of chronic hypopituitarism resulting from postpartum pituitary necrosis. Am J Obstet Gynecol. Nov 1971;111(6):852-4. [Medline].

  49. Tucker HA. Endocrinology of lactation. Semin Perinatol. Jul 1979;3(3):199-223. [Medline].

  50. Turkington RW. Phenothiazine stimulation test for prolactin reserve: the syndrome of isolated prolactin deficiency. J Clin Endocrinol Metab. Jan 1972;34(1):246-9. [Medline].

  51. Tyson JE, Perez A, Zanartu J. Human lactational response to oral thyrotropin releasing hormone. J Clin Endocrinol Metab. Oct 1976;43(4):760-8. [Medline].

  52. Weinstein LS, Liu J, Sakamoto A, et al. Minireview: GNAS: normal and abnormal functions. Endocrinology. Dec 2004;145(12):5459-64. [Medline]. [Full Text].

  53. Wettschureck N, Offermanns S. Mammalian G proteins and their cell type specific functions. Physiol Rev. Oct 2005;85(4):1159-204. [Medline]. [Full Text].

  54. Yazigi RA, Quintero CH, Salameh WA. Prolactin disorders. Fertil Steril. Feb 1997;67(2):215-25. [Medline].

  55. Ylikorkala O, Kivinen S, Kauppila A. Oral administration of TRH in puerperal women: effect on insufficient lactation, thyroid hormones and on the responses of TSH and prolactin to intravenous TRH. Acta Endocrinol (Copenh). Apr 1980;93(4):413-8. [Medline].

  56. Yoneda N, Irahara M, Saito S, et al. Usefulness of recombinant human prolactin for treatment of poor puerperal lactation in a rat model. Eur J Endocrinol. Nov 1995;133(5):613-7. [Medline].

[ CLOSE WINDOW ]

Keywords

prolactin deficiency, hypoprolactinemia, hypoprolactinemic states, puerperal alactogenesis, familial puerperal alactogenesis, pituitary dysfunction, anterior pituitary dysfunction, postpartum pituitary necrosis, Sheehan syndrome, lymphocytic hypophysitis, general anterior pituitary dysfunction, anterior pituitary impairment, hypopituitarism, inability of pituitary lactotrophs to secrete prolactin, lack of puerperal lactogenesis, inadequate breast milk production, inadequate lactation, inability to lactate, inability to breast-feed

[ CLOSE WINDOW ]

Contributor Information and Disclosures

Author

Charles T Benson, MD, PhD, Medical Advisor, Eli Lilly and Company, UK
Disclosure: Eli Lilly & Co Salary Employment

Medical Editor

Frederick H Ziel, MD, Associate Professor of Medicine, David Geffen School of Medicine at UCLA; Physician-In-Charge, Endocrinology/Diabetes Center, Director of Medical Education, Kaiser Permanente Woodland Hills; Chair of Endocrinology, Co-Chair of Diabetes Complete Care Program, Southern California Permanente Medical Group
Frederick H Ziel, MD is a member of the following medical societies: American Association of Clinical Endocrinologists, American College of Endocrinology, American College of Physicians, American College of Physicians-American Society of Internal Medicine, American Diabetes Association, American Federation for Medical Research, American Medical Association, American Society for Bone and Mineral Research, California Medical Association, Endocrine Society, and International Society for Clinical Densitometry
Disclosure: Nothing to disclose.

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: eMedicine Salary Employment

Managing Editor

Yoram Shenker, MD, Chief of Endocrinology Section, Veterans Affairs Medical Center of Madison; Interim Chief, Associate Professor, Department of Internal Medicine, Section of Endocrinology, Diabetes and Metabolism, University of Wisconsin at Madison
Yoram Shenker, MD is a member of the following medical societies: American Heart Association, Central Society for Clinical Research, and Endocrine Society
Disclosure: Nothing to disclose.

CME Editor

Mark Cooper, MBBS, PhD, FRACP, Head, Diabetes & Metabolism Division, Baker Heart Research Institute, Professor of Medicine, Monash University
Disclosure: Nothing to disclose.

Chief Editor

George T Griffing, MD, Professor of Medicine, St Louis University School of Medicine
George T Griffing, MD is a member of the following medical societies: American Association for the Advancement of Science, American College of Medical Practice Executives, American College of Physician Executives, American College of Physicians, American Diabetes Association, American Federation for Medical Research, American Heart Association, Central Society for Clinical Research, Endocrine Society, International Society for Clinical Densitometry, and Southern Society for Clinical Investigation
Disclosure: Nothing to disclose.

 
 
HONcode

We subscribe to the
HONcode principles of the
Health On the Net Foundation

All material on this website is protected by copyright, Copyright© 1994- by Medscape.
This website also contains material copyrighted by 3rd parties.

DISCLAIMER: The content of this Website is not influenced by sponsors. The site is designed primarily for use by qualified physicians and other medical professionals. The information contained herein should NOT be used as a substitute for the advice of an appropriately qualified and licensed physician or other health care provider. The information provided here is for educational and informational purposes only. In no way should it be considered as offering medical advice. Please check with a physician if you suspect you are ill.