Prolactin Secretion in the Empty Sella Syndrome, in Prolactinomas and in Acromegaly

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Abstract
Prolactin (PRL) secretion was studied in 47 patients with empty sella syndrome. Hyperprolactinemia (39-123 .mu.g/l) was found in 6 of them. Intermittent increases in PRL were noted in another 7 patients. In most subjects with empty sella syndrome and hyperprolactinemia, diurnal PRL variation was altered or impaired; the PRL response to TRH [thyrotropin releasing hormone] and L-dopa was normal. Low doses of bromocriptine (3.75-5 mg/day) normalized PRL. In patients with prolactinoma and acromegaly who had PRL levels of 30-165 .mu.g/l the diurnal PRL variation and PRL response to TRH were impaired. Patients with prolactinoma failed to suppress PRL during L-dopa test. The dose of bromocriptine required to normalize PRL ranged between 7.5 and 15 mg/day. In subjects with sellar changes and intrasellar cisternal herniation (empty sella), and with moderate increases in PRL, the responses to TRH and L-dopa and to bromocriptine may help to differentiate between the empty sella syndrome and a coexisting pituitary tumor.