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      Delayed Puberty and Hypoplastic Uterus Associated with Hyperprolactinemia: Successful Treatment with Bromocriptine

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      Hormone Research in Paediatrics

      S. Karger AG

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          A 15-year-old girl referred because of primary amenorrhea was found to have a hypoplastic uterus and persistent hyperprolactinemia (72–110 ng/ml). The gonadotrophin-dependent pubertal signs, i.e. breast and vulvar development, were significantly retarded (Tanner stage 2–3) while sexual hair was well developed; bone age was 13 years. The endocrinological evaluation revealed gonadotrophin secretion (LH – basal: 0.85–1.25; peak after LH-RH: 10.4 mlU/ml; FSH – basal: 1.63–2.5; peak: 8.2 mlU/ml) and E<sub>2</sub> levels (26–68 pg/ml) which were appropriate for Tanner stage 3. The high basal levels of PRL were nonresponsive to either stimulatory (TRH) or inhibitory (nomifensine) agents. CT scan of the brain suggested the presence of a pituitary microadenoma. Following therapy with bromocriptine (2.5 mg/day) plasma PRL levels dropped to normal (5–6.8 ng/ml) with an accompanying catch-up of pubertal development and linear growth and a marked increase in size of the uterus as documented by repeated ultrasonographic examinations. Menarche occurred 5 months after initiation of therapy, followed by regular menses thereafter. Repeated CT scan of the brain showed a decrease in the density and size of the still persisting lesion. This patient demonstrates that hyperprolactinemia can cause delayed puberty with a particular inhibitory effect on uterine growth and development.

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          Author and article information

          Horm Res Paediatr
          Hormone Research in Paediatrics
          S. Karger AG
          26 November 2008
          : 22
          : 1-2
          : 68-73
          Institute of Pediatric and Adolescent Endocrinology, Department of Obstetrics and Gynecology, Division of Ultrasound, Neuroradiology Unit, Beilinson Medical Center and Sackler School of Medicine, Tel Aviv University, Israel
          180074 Horm Res 1985;22:68–73
          © 1985 S. Karger AG, Basel

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          Page count
          Pages: 6
          Pediatric Endocrinology


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