Dynamic evaluation of hypothalamic-pituitary function in women with the syndrome of galactorrhea
Kawagoe, S.; Saito, H.; Ogawa, T.; Hiroi, M.
Nihon Sanka Fujinka Gakkai Zasshi 34(1): 61-69
1982
ISSN/ISBN: 0300-9165 PMID: 6801158 Document Number: 192487
To elucidate the pathophysiology underlying the galactorrheic patient, various types of stimulation and suppression tests to the hypothalamic-pituitary axis were performed in 38 women with inappropriate lactation. Pituitary tumor was demonstrated in 5 patients by skull X-rays (group 1). Baseline PRL concentrations (6.2 .+-. 1.6 mIU/ml) of group 1 were significantly (P < 0.1) lower than those of group 2 and group 3. In patients of group 1, synthetic LHRH administration (100 .mu.g, i.m.) did not induce the significant increase in serum LH levels, while LH release in response to the LHRH stimulus was observed in the patients of group 2 and group 3. The patients of group 1 also showed no pituitary PRL responses to PRL stimulation and inhibition tests utilizing TRH (500 .mu.g, i.m.), sulpiride (150 mg, p.p.) and L-dopa (500 mg, orally). Bromocriptine (2.5 mg) resulted in a decrease in serum PRL 120-180 min after its ingestion. In these patients with pituitary tumor, i.v. injection of Premarin (20 mg) did not influence the serum concentrations of gonadotropins during the study period. The patients (group 3) with galactorrhea, but not hyperprolactinemia, showed normal responses to these stimulation and suppression tests. The patients of group 2 also showed almost the same response patterns of gonadotropins and PRL. The majority of the patients with inappropriate lactation, except for the cases with pituitary tumor, keep almost normal functional capacity of hypothalamic-pituitary system, and raised serum PRL has no direct inhibitory influence on that system in terms of pituitary responses to the various stimuli.