Coexisting Prolactinoma and Primary Aldosteronism: Is There a Pathophysiological Link?


Coexisting prolactinoma-primary aldosteronism (PA) is infrequently reported. The objective of the study was to identify patients with prolactinoma-PA and test the hypothesis that elevated prolactin (PRL) concentrations play a role in PA pathogenesis. Seven patients with prolactinoma-PA were identified: four of 584 and three of 442 patients from the Munich and Turin PA cohorts, respectively. A disproportionate number presented with macroprolactinomas (five of seven). There were five cases of hyperprolactinemia with no cases of macroprolactinoma of 14 790 patients in a general EH cohort. In a population of PA patients case-control matched 1:3 with EH patients there were two cases of hyperprolactinemia of 270 PA patients and no cases in the EH cohort (n = 810). PRLR gene expression was significantly up-regulated in the aldosterone-producing adenomas compared with normal adrenals (1.7-fold and 1.5-fold by microarray and real-time PCR, respectively). In H295R cells, PRL treatment resulted in 1.3-fold increases in CYP11B2 expression and aldosterone production. Elevated PRL caused by systemic hyperprolactinemia may contribute to the development of PA in those cases in which the two entities coexist.

Authors: Tracy Ann Williams, Anna S. Dietz, Marily Theodoropoulou, Anna Riester, Evelyn Fischer, Jacopo Burrello, Marcus Treitl, Lucas Geyer, Franco Veglio, Martin Bidlingmaier, Jochen Schopohl, Felix Beuschlein, Paolo Mulatero, Martin Reincke
Keywords: prolactinoma, primary aldosteronism
DOI Number: 10.1210/JC.2015-2422      Publication Year: 2015

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