Diagnostic and therapeutic approach of hyperprolactinemia in primary care

Enfoque diagnóstico y tratamiento de hiperprolactinemia en la atención primaria

Introduction: hyperprolactinemia is a common condition with multiple etiologies which may be faced by primary care physicians. Objective: to review the updated literature on the diagnostic and therapeutic approach to hyperprolactinemia. Materials and methods: a narrative review of the literature by searching for articles in Medline through Pubmed, SciELO and LILACS. The strategy was developed using Medical Subject Heading Terms (MeSH): hyperprolactinemia, prolactinoma, differential diagnosis, in English, and hiperprolactinemia, prolactinoma, diagnóstico diferencial, in Spanish. Boolean operators “AND” “OR” were used individually or jointly, to obtain concrete and targeted results. Results and Discussion: causes other than pituitary conditions, are very common, including those of physiological, pharmacologic, and tumoral origin or secondary to systemic disorders. A complete clinical history is essential to evaluate the symptoms, or the intake of some medications related to hyperprolactinemia, to arrive at the correct etiology. Conclusions: the diagnostic approach should be oriented towards identifying patients who require further evaluation and management with dopamine agonists, which is reserved for cases with specific indications.