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CPE-006 · Classification
HG-07: Hyperprolactinemia with low testosterone
Hyperprolactinemia with low testosterone. Evaluates prolactin above the laboratory upper limit.
Active rulePriority 2Testosterone engine v1.0.0
Condition
- prolactin above the laboratory upper limit
- low total testosterone
What it reports
- Priority: a raised prolactin can suppress testosterone and may reflect a pituitary lesion, medication or another cause
Recommended next steps (for physician review)
- Consider pituitary imaging when prolactin is clearly raised or there are mass-effect symptoms
- Review prolactin-raising drugs (antipsychotics, metoclopramide), hypothyroidism, renal failure and macroprolactinemia
- Address the cause before testosterone therapy is weighed
Diagnostic boundary
- Does not diagnose a prolactinoma.
Evidence
- EV-ES-PRL-2011Melmed S, Casanueva FF, Hoffman AR, et al. Diagnosis and treatment of hyperprolactinemia: an Endocrine Society Clinical Practice Guideline. J Clin Endocrinol Metab. 2011;96(2):273-288.Supports: Causes of raised prolactin, including drugs and macroprolactin; when to image the pituitary
Cases where this rule fires
Open a case to see this rule fire with real inputs, then change the values until it stops.
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