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2nd opinion for high prolactin level
Jul 23, 2006

I have been positive for 12 year, never been on medication and never been sick, my viral load is about 11000copies/ml and my cd4 count is about 400. I am considering on having a baby so I did lots of fertility test which showed that my prolactin level was too high at about 1500, test were repeated at least 3-4 times while fasting and rested but no significant change. I was sent for MRI scan to check for any tumor but nothing abnormal was detected but radiographist suggested a possibility of a condition called leuconcephalopathy, I looked up the word on internet and it gave me a scare. I took my result to my physician and asked him if it is time to start with ARVs but he said it is not neccesary, he only sent me for other tests before he could start treated the raised prolactin, only if I am still planning to get pregnant.

Do you thing the radiologist suggestion should be ignored in totality or perhaps it is time to start medication? I need your advice

Response from Dr. Pierone

When a high blood prolactin level is identified and confirmed, as in your case, an MRI scan of the pituitary gland is usually recommended. The pituitary produces the hormone prolactin and if a pituitary tumor is present it can lead to the overproduction of prolactin and higher than normal levels in the blood. There are numerous other causes for high prolactin and your doctor should be able to guide you through the evaluation. An endocrinologist may also be helpful to sort this out. It's not clear from your post if the radiologist made a diagnosis of leucoencephalopathy on the basis of the MRI scan or if the MRI scan was entirely normal.

From the information you have provided it does not sound like you need to commence antiretroviral therapy at this time.

Best of luck to you and let us know how things turn out.



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