The TSH response to domperidone reflects the biological activity of prolactin in macroprolactinaemia and hyperprolactinaemia.

Abstract:

OBJECTIVE:To test the hypothesis that patients with hyperprolactinaemia due to biologically inactive macroprolactin will not show the characteristically increased dopaminergic inhibition of TSH release seen in patients with microprolactinomas secreting biologically active monomeric PRL. DESIGN:Comparison of the TSH and PRL responses to dopamine antagonism with domperidone (10 mg i.v.) in patients with hyperprolactinaemia due to macroprolactinaemia or microprolactinomas. PATIENTS:Twenty-two patients referred for the investigation of their hyperprolactinaemia were studied: 11 patients with macroprolactinaemia and 11 patients with hyperprolactinaemia due to microprolactinoma. MEASUREMENTS:TSH and PRL levels were measured at baseline and 30 min following domperidone in both groups. RESULTS:Patients with macroprolactinaemia showed normal TSH and PRL responses to dopamine antagonism whereas patients with microprolactinomas showed exaggerated TSH responses and reduced PRL responses. Although there was considerable overlap between the PRL responses in the two groups, there was very clear separation between the PRL/TSH response ratios (normal > 1.0) of 4.0 +/- 1.8 for the macroprolactinaemia group and 0.4 +/- 0.2 for the microprolactinoma group (P < 0.0001). CONCLUSIONS:These data support the hypothesis that elevated circulating levels of macroprolactin, as opposed to biologically active monomeric PRL, do not exert increased positive feedback on the hypothalamic dopaminergic inhibition of TSH release.

journal_name

Clin Endocrinol (Oxf)

journal_title

Clinical endocrinology

authors

Pinto LP,Hanna FW,Evans LM,Davies JS,John R,Scanlon MF

doi

10.1046/j.1365-2265.2003.01887.x

keywords:

subject

Has Abstract

pub_date

2003-11-01 00:00:00

pages

580-4

issue

5

eissn

0300-0664

issn

1365-2265

pii

1887

journal_volume

59

pub_type

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