Unusual Case of Hirsutism From Prolactinoma Induced Dihydrotestosterone Elevation

    October 2023 in “ Journal of the Endocrine Society ”
    Jayachidambaram Ambalavanan, Kenda Alkwatli, Lily Tranchito, Divya Yogi-Morren, Pratibha Rao
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    TLDR A woman's excessive hair growth was linked to a rare case of high testosterone caused by a prolactin-producing pituitary tumor.
    A 31-year-old female presented with hirsutism and elevated prolactin (PRL) levels due to a prolactinoma, which led to increased dihydrotestosterone (DHT) levels. Initial tests showed subclinical hypothyroidism, high PRL (49 ng/ml), and high DHT (871 pg/ml), with other androgen markers normal. After treatment with levothyroxine and finasteride, and subsequent cabergoline for the prolactinoma, her PRL and DHT levels normalized. This case highlights a rare instance where elevated PRL was associated with high DHT, suggesting prolactin's potential role in activating the 5 alpha reductase enzyme, thus increasing DHT levels. This association is not well-documented in humans, warranting further awareness in the endocrine community.
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