[Polycystic ovary syndrome associated with remarkable hyperprolactinemia--case report].

UNLABELLED: Polycystic Ovary Syndrome is a common disorder in young women but its etiology and pathogenesis are not completely understood. Clinical manifestations include irregular menses, hirsutism, and acne. An inappropriate secretion of many hormones is observed, including elevated serum prolactin concentrations. It is difficult to precise the level of prolactin elevation, few studies report the values of serum prolactin, most authors describe solely mild prolactin elevation. We report a case of an 18-years-old female with an extremely high serum prolactin concentration of 2364 microU/ml (reference range 70-510 microU/ml) observed in the course of PCOS. In this patient MRI scan ruled out the presence of a pituitary adenoma. Menstrual disturbances occurred after the first menses, including oligomenorrhea and secondary amenorrhea. Hirsutism was present. The patient's height, weight and BMI were 167 cm, 106 kg, and 38 kg/m2, respectively. The hormone serum concentrations: free testosterone--4.4 pg/ml (rr 0.4-2.6 pg/ml), follitropin (FSH)--5.14 mU/ml, lutropin (LH)--8.76 mU/ml, dehydroepiandrostendion sulfate (DHEA-S)--564.8 microg/dl (rr for menstruating women 70.0-300.0 microg/dl), insulin 22.0 microU/ml (rr 3.0-17.0 microU/m). Fasting plasma glucose was 70 mg/dl, and in 2-hours OGTT it was 135 mg/dl. Intravaginal USG revealed ovaries typical for PCOS, i.e. polycystic-appearing ovaries (PAO).

CONCLUSIONS: functional hyperprolactinemia in PCOS may be remarkably high, reaching concentrations similar to those in pituitary prolactinomas.