Mary’s Battle with Hyperprolactinemia: Cholecystokinin

January 14, 2024by Dr. S. F. Czar0

Case Study: 

Patient Profile:
  • Name: Mary Johnson
  • Age: 32 years
  • Gender: Female
  • Medical History: Generally healthy, no significant medical conditions.
Presenting Problem:

Mary Johnson visited her primary care physician complaining of irregular menstrual cycles and a milky discharge from her breasts. She had been trying to conceive with her husband for over a year without success. Her physician ordered blood tests, including hormone levels, and the results indicated significantly elevated prolactin levels (hyperprolactinemia).

Diagnostic Workup:
  • Blood Tests: Mary’s serum prolactin levels were found to be consistently elevated at 90 ng/mL (normal range: 2-18 ng/mL).
  • Imaging: An MRI scan of the brain was performed to rule out any pituitary tumors that might be causing the hyperprolactinemia. The MRI showed a small microadenoma in the pituitary gland.
Treatment Options:

Given Mary’s elevated prolactin levels and the presence of a pituitary microadenoma, her endocrinologist discussed various treatment options:

  • Dopamine Agonists: The standard treatment for hyperprolactinemia caused by pituitary tumors is dopamine agonist therapy, such as cabergoline or bromocriptine. These drugs work by reducing prolactin secretion from the pituitary gland.
  • Cholecystokinin (CCK) Therapy: Mary’s endocrinologist mentioned a novel approach involving cholecystokinin (CCK) therapy, which has shown promise in reducing prolactin levels in some preliminary studies. CCK would be administered via subcutaneous injections.
Treatment Plan:

Mary opted to participate in a clinical trial exploring the potential use of CCK as a treatment for hyperprolactinemia. Her treatment plan included:

  • Baseline Assessment: A thorough assessment of Mary’s hormonal profile and pituitary function was conducted before starting treatment.
  • CCK Administration: Mary received subcutaneous CCK injections three times a week for a duration of three months.
  • Monitoring: Throughout the treatment period, Mary’s hormone levels were closely monitored, and any side effects or adverse reactions were documented.
Outcome:

After three months of CCK therapy, Mary’s serum prolactin levels were reevaluated. The results showed a significant reduction in prolactin levels, which had returned to the normal range (14 ng/mL). Additionally, her menstrual cycles became regular, and the milky discharge from her breasts ceased.

Discussion:

Mary’s case highlights the potential of CCK as an alternative treatment for hyperprolactinemia, especially in cases where dopamine agonists may be less effective or not well-tolerated. The use of CCK in this clinical trial demonstrated promising results, providing a potential avenue for individuals like Mary to manage their condition and improve their fertility.

Note: This case study is entirely fictional and for illustrative purposes only. Real medical cases should be managed by healthcare professionals following established guidelines and protocols.

Emily Johnson and Her Pituitary Disorder

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