We had a patient who came to us for infertility. She had galactorrhea, but was otherwise normal. Her investigations were normal, including serum prolactin (10 ng/ml). Actually she should have been assured that all was OK and she should proceed with evaluation and treatment of infertility. Unfortunately one consultant put her on bromocriptine. She took that medication for two weeks. Then someone realized she had to undergo hysteroscopy and laparoscopy for evaluation of infertility.
"Sir, shall we post her for endoscopy?"
"Yes" I said after checking all of her reports. There was no need to treat galactorrhea when there was no endocrine abnormality. I was unhappy with her bromocriptine therapy, but it could not be undone.
When I reached the OT the next day, I had a surprise waiting.
"Sir, we got an endocrinologist's opinion while she was in the ward awaiting surgery" my Registrar told me. "He advised serum prolactin, T3, T4 and TSH assay."
"What were the results?" I asked.
"The hyroid function is OK. The serum prolactin level is 0.2 ng/ml."
I was aghast. I had not seen such a low level any time."
"We shall call this iatrogenic hypoprolactinemia" I said.
"Sir, the patient is OK."
"God be praised" I said.
"Sir, shall we post her for endoscopy?"
"Yes" I said after checking all of her reports. There was no need to treat galactorrhea when there was no endocrine abnormality. I was unhappy with her bromocriptine therapy, but it could not be undone.
When I reached the OT the next day, I had a surprise waiting.
"Sir, we got an endocrinologist's opinion while she was in the ward awaiting surgery" my Registrar told me. "He advised serum prolactin, T3, T4 and TSH assay."
"What were the results?" I asked.
"The hyroid function is OK. The serum prolactin level is 0.2 ng/ml."
I was aghast. I had not seen such a low level any time."
"We shall call this iatrogenic hypoprolactinemia" I said.
"Sir, the patient is OK."
"God be praised" I said.
