A Case of Telogen Effluvium Associated with Drug-Induced Hyperprolactinemia

    January 2020 in “ Nihon rinsho hifukaikai zasshi
    Kaori Nonogaki, Rie Ueki
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    TLDR A woman's temporary hair loss was caused by high prolactin levels from her medication.
    In 2020, a case study was conducted on a 77-year-old woman who had been taking olanzapine, valproic acid, and trazodone for dementia for about 2 years. A month before her first visit, risperidone was added to her medication regimen, after which her family noticed a significant decrease in her hair volume and an increase in hair shedding. Upon examination, diffuse hair loss and easy hair pullability were observed, but no pathological hair was found. A biopsy showed an increase in hair follicles in the resting phase, and no inflammatory cell infiltration was observed. Her serum prolactin (PRL) level was high at 137.7 ng/ml. The researchers concluded that the woman had telogen effluvium, a form of temporary hair loss, due to drug-induced hyperprolactinemia. After gradually discontinuing risperidone, her PRL level dropped to 67.1 ng/ml after 3 months, and her hair loss improved with a visible increase in hair volume. The study suggested that drug-induced telogen effluvium can be difficult to notice and should be considered in differential diagnosis when diffuse hair loss occurs.
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