Hyperprolactinaemia

Drugs causing hyperprolactin: Dopamine agonist eg. Metoclopramide, Phenothiazines, SSRI


Important causes : Most common physiological (pregnancy and lactation), Microprolactinoma, Hypothyroidism, Cirrhosis and renal impairment.

Antibodies and Thyroid Diseases

Hypothyroidism : Antimicrosomal Ab, Anti TPO Ab, Anti Thyroglobulin Ab


Hyperthyroidism : TSH Receptor stimulating Antibody ( Grave's)

Thyroid Malignancy

Pappilary : Most common, slowest growing, distant metastases rare, thyroglobulin tumour marker

Follicular : 2nd common, more aggressive than papillary, both local and distant metastasis

Anaplastic : Most aggresive, painful rapidly expansion, worst prognosis

Medullary : Associated with MEN 2, Calcitonin tumour marker, early total thyroidectomy curative.

Lymphoma : as generalized lymphoma or thyroid only.

Metabolic Bone Diseases

Osteomalacia : Low calcium, low phosphate, high alkaline phosphatase,high PTH

1* Hyperparathyroidism: High Calcium, low phosphate, normal alk.phos, high PTH

Paget's Diseases: Normal Calcium, Normal phosphate, high Alk.Phos, normal PTH


2* Hyperparathyroidism: Low calcium, High Phosphate, Normal Alk.Phos,High PTH

Hypervitaminosis D: High Calcium, High Phosphate, Normal Alk.Phos, low PTH