This Journal feature begins with a case vignette highlightinga common clinical problem. Evidence supporting various strategiesis then presented, followed by a review of formal guidelines,when they exist. The article ends with the author's clinicalrecommendations.
A 22-year-old woman who wants to become pregnant has had nomenses since she discontinued the use of an oral contraceptiveone year ago, and recently, galactorrhea developed. She takesno medications and has had no headaches, visual loss, dyspareunia,or decreased libido. Physical examination shows no abnormalities,except for the bilateral breast discharge. A test for serumhuman chorionic gonadotropin is . . . [Full Text of this Article]
The Clinical Problem
Clinical Presentation
Causes of Hyperprolactinemia
Strategies and Evidence
Diagnostic Studies
Therapy
Microadenomas
Macroadenomas
Hypogonadism
Areas of Uncertainty
Guidelines
Conclusions and Recommendations
Source Information
From the Department of Internal Medicine, University of Iowa, Iowa City.
Address reprint requests to Dr. Schlechte at the Department of Internal Medicine, 157 MRF, University of Iowa Hospitals and Clinics, 200 Hawkins Dr., Iowa City, IA 52242, or at janet-schlechte@uiowa.edu.
Related Letters:
Prolactinomas
Friedman T. C., Couldwell W. T., Weiss M. H., Laws E. R. Jr., Hortin G. L., Colao A., Lombardi G., Schlechte J.
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N Engl J Med 2004;
350:1054-1057, Mar 4, 2004.
Correspondence
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