patient 20 female unmarried,amnerrhoea 5 months.thyroid level is normal
Hyperprolactinemia itself causes amenorrhea As prolactin is very high go CT head to rule out pituitary adenoma ... Give cabergoline 0. 5 mg twice weekly for 6 weeks Repeat erum prolactin after 6 weeks
Prolactin level is very high suggestive of Pituitary Adenoma Adv CT brain to rule out the further tt after reports of CT only.
Go for TPO antibodies, antimicrosomal antibodies Rule out hassimoto thyroiditis. Put on eltroxin 150mcg daily reassess her after 2months
PRL more than 100 is suggestive of macroadenomas of pituitary gland. Take a CTbrain rule out mass. Fundus examination I also must be done for visual defects. Opinion of a neuro surgeon later
Serum prolactin of this level and normal thyroid functions after ruling out drugs causing hyperprolactinemia ,should go for contrast enhanced MRI of pituitary.
See & test for any H/o pregnancy.
a case of hyperprolactinaemia gravindex test tobe done if negative give tab cabergoline after15 days repeat serum prolactin do her ct brain to exclude pituitary tumour reassure the pt
mri brain fot pituitary adenoma. meanwhile do bhcg.
Go for prolactin level
Raised prolactin..do her detail examination..check for galactorrhea.do MRI brain for pituitary tumors..and start with tab cabergoline
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*Chief complaint* A 31-year-old male was diagnosed with Pituitary gland tumor. *History* He was having hair loss along with fatigue & lethargy 6 months back. He consulted a doctor who prescribed regular tests + testosterone test. He also complains of weight gain. *Physical examination* He is a healthy male with no other disease. *Investigations* All reports are attached with the case and rest in the comments. His consulting doctor has prescribed regular tests + testosterone test 6 months back. In which Testosterone level was low. He repeated the test after 6 months then the testosterone level was even lower so he consulted an endocrinologist who asked for MRI Brain. Then he was diagnosed with Pituitary gland tumor. The difference in cortical level in 2 reports is because 1 test was done empty stomach and the other test was done after having 1 tablet (He dont remember the name) at night and repeat the test in the morning. This is why there is a difference in the level of serum cortisol. *Diagnosis* Pituitary gland Tumor *Treatment* 1) Could this tumor show growth in the future? 2) Is surgery needed? 3) What is the treatment - Only hormonal therapy or other treatment for tumor also? 4) What is management for his weight gain? Please ask any question you need to ask and give your valuable opinion.
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