Prolactinoma (Pituitary Adenoma) |
- Galactorrhoea (bilateral, milky discharge)
- Menstrual irregularities (e.g., amenorrhea)
- Infertility
- Headaches and visual disturbances (due to tumour compression)
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- Serum Prolactin Levels: Elevated levels.
- MRI of the Brain: To detect pituitary adenoma.
- Visual Field Testing: To assess for bitemporal hemianopsia.
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- Dopamine Agonists: Medications like cabergoline or bromocriptine to reduce prolactin levels and shrink the tumour.
- Surgery: Trans sphenoidal surgery for large or unresponsive tumours.
- Radiation Therapy: Considered if the tumour is not fully resectable.
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Hypothyroidism |
- Galactorrhoea
- Fatigue
- Weight gain
- Cold intolerance
- Dry skin and hair loss
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- Serum TSH Levels: Elevated TSH with low free T4.
- Serum Prolactin Levels: May be mildly elevated.
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- Thyroid Hormone Replacement: Levothyroxine to normalize thyroid function and reduce prolactin levels.
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Medications (e.g., Antipsychotics, Antidepressants) |
- Galactorrhoea
- Possible menstrual irregularities
- Symptoms related to the underlying condition being treated (e.g., psychosis, depression)
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- Medication History: Review of current and recent medications.
- Serum Prolactin Levels: May be elevated due to drug effects.
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- Discontinuation or Switching: Discontinuing or switching the causative medication if possible.
- Dopamine Agonists: Considered if medication cannot be discontinued and symptoms are severe.
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Chronic Kidney Disease (CKD) |
- Galactorrhoea
- Signs of CKD (e.g., oedema, fatigue, nausea)
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- Serum Creatinine and BUN: Elevated levels indicate kidney dysfunction.
- Serum Prolactin Levels: May be elevated due to decreased clearance by the kidneys.
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- Management of CKD: Includes dialysis or kidney transplant in advanced cases.
- Prolactin Management: Dopamine agonists may be used if galactorrhea is symptomatic.
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Idiopathic Galactorrhoea |
- Galactorrhoea without an identifiable cause
- Normal menstrual cycles
- No significant medical history
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- Diagnosis of Exclusion: All other causes are ruled out.
- Serum Prolactin Levels: May be mildly elevated or normal.
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- Observation: Regular monitoring if asymptomatic and no underlying cause is identified.
- Dopamine Agonists: Used if symptoms are bothersome.
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