HCA Florida Northwest Hospital
multiple sclerosis, prolactinoma, autoimmune diseases
Immune System Diseases | Internal Medicine | Medicine and Health Sciences | Neoplasms | Nervous System Diseases
Among disorders affecting the central nervous system (CNS), excluding trauma, multiple sclerosis (MS) is the most common cause of permanent disability in young adults. This condition is characterized by IgG autoantibody-mediated destruction of oligodendrocytes in the brain and spinal cord. Although the origin of MS is not fully understood, some suggest that prolactin may be involved in the development of the disease process evidenced by the fact that it predominately affects women of childbearing age, and the diverse role of prolactin (PRL) as a peptide hormone, cytokine, and immune modulator. Here we review the case of a 32-year-old female with history of a prolactinoma and MS presenting to HCA with an acute flare. In 2022, the patient presented to her physician with blurred vision in bilateral temporal fields, amenorrhea, and galactorrhea. She was found to have elevated serum prolactin and a 4.7 x 2 mm left lateral pituitary microadenoma on magnetic resonance imaging (MRI). She was subsequently diagnosed with a prolactinoma, and treated with cabergoline after which her symptoms resolved. Following a repeat MRI, the microadenoma from the previous year was redemonstrated, and, notably, new lesions in the periventricular white matter were discovered. Upon further work up, she was ultimately diagnosed with MS. Through this case, we may be able to better understand the involvement of PRL in the inflammatory process and triggering of autoimmune disease, such as MS.
Ali, Aleeza; Simon, Jesse; and Bamgboye, Adekunle, "Multiple Sclerosis in a 32-Year-old Female with History of Prolactinoma" (2023). East Florida Research Day 2023. 22.