Risk of thromboembolic events in patients with prolactinomas compared with patients with nonfunctional pituitary adenomas

Abstract

Prolactin has been proposed as a potent coactivator of platelet aggregation, possibly contributing to thromboembolic events. The objective of the study was to evaluate the relationship between prolactinoma and deep vein thrombosis (DVT), pulmonary embolism (PE), and cerebrovascular accident (CVA). Subjects were identified from a prospectively maintained pituitary database at the Cleveland Clinic. We retrospectively reviewed the charts of 544 subjects: 347 patients with prolactinomas (prolactinoma group) and 197 patients with nonfunctional pituitary adenomas (control group). Main outcome measures were DVT, PE and CVA. We found that 19 (5.5%) patients in the prolactinoma group and five (2.5%) patients in the control group had documented DVT, PE, or CVA, but this difference was not significant (p = 0.109). However, the mean initial prolactin level was higher at the time of diagnosis among prolactinoma patients than among controls (815.23 ng/ml vs. 15.90 ng/ml; p < 0.001). Among prolactinoma patients, 15 (5.5%) of 275 patients who underwent medical treatment (with cabergoline, bromocriptine, pergolide and/or other drug) and 4 (5.6%) of 72 patients who underwent transsphenoidal surgery had documented DVT, PE, or CVA, which suggests that dopaminergic therapy did not influence the risk of thromboembolic events. Hyperprolactinemia per se does not appear to predispose to a hypercoagulable state.

The Effects of Novel and Newly Approved Antipsychotics on Serum Prolactin Levels: A Comprehensive Review

“…PRL concentration also correlates with tumor size [5, 116]. A serum PRL level >200–250 ng/ml is usually due to a macroadenoma (>1 cm in diameter), rather than a microadenoma (<1 cm diameter) [116, 117]. In the event of a macroprolactinoma, the PRL concentration can even rise to values as high as 35,000 ng/ml (see Table 2).…”

The influence of hyperprolactinemia on coagulation parameters in females with prolactinomas

“…They found that platelet activity during pregnancy was comparable to non-pregnant state, therefore no significant effect of PRL on platelet function in vivo was observed. Mon SY et al [20] did not find a significant rate of deep vein thrombosis, pulmonary embolism and cerebrovascular accidents in prolactinoma patients. According to these results they concluded that hyperprolactinemia per se did not appear to predispose to hypercoagulable state.…”

The effect of prolactin levels on MPV in women with PCOS

“…demonstrated that hyperprolactinaemia in pregnancy was not associated with increased in vivo platelet activity and counts . Similarly, Mon et al . reported that they did not observe a higher rate of thromboembolic events in patients with prolactinoma compared to controls.…”