Abstract
A 15 year-old-girl referred because of primary amenorrhea was found to have a hypoplastic uterus and persistent hyperprolactinemia (72-110 ng/ml). Pubertal development was retarded: breasts Tanner stage 3, pubic hair - Tanner stage 4, bone age was 13 yrs. Endocrinological examinations revealed: LH- basal 0.85, peak after LRH- 5.04 mIU/ml; FSH- basal 4.27, peak 12.88 mIU/ml; PRL response to TRH- basal 79.2, peak 101.6 ng/ml, and no suppression after Nomifensine (125 mg orally). CT of the brain was suggestive for a pituitary microadenoma. Following therapy with bromocriptine (2.5 mg/day) PRL levels dropped to 5-6.8 ng/ml with accompanying pubertal development and a marked growth of the uterus, as documented by repeated ultrasound examinations. Menarche occurred 5 months after the initiation of therapy followed by regular mensis thereafter. During the 4 yrs of therapy she grew 9.1 cm. Repeated CT of brain showed a decrease in the density and size of the lesion, which however persisted. This patient demonstrates that hyperprolactinemia can cause delayed puberty with a particular inhibitory effect on uterine growth and development.
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Kauli, R., Schoenfeld, A., Ovadia, Y. et al. Delayed puberty and hypoplastic uterus associated with hyperprolactinemia and successfully treated with bromocriptine. Pediatr Res 18, 1228 (1984). https://doi.org/10.1203/00006450-198411000-00162
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DOI: https://doi.org/10.1203/00006450-198411000-00162