Hyperprolactinemia Associated With Empty Sella Syndrome

SINCE the radioimmunoassay of human prolactin became available, hyperprolactinemia has been demonstrated in a number of pathological states.1An elevated basal prolactin concentration of more than 200 ng/ml is generally regarded as strong evidence in favor of an adenomatous pituitary lesion.2Our patient had substantial hyperprolactinemia associated with the empty sella syndrome. Report of a Case A 37-year-old woman was referred to The Johns Hopkins Hospital in December 1973 because of persistent generalized headaches of five years' duration. Three years prior to admission, she underwent extensive examinations in another hospital. Skull roentgenograms had shown enlargement of the sella turcica, with erosion of the dorsum sellae (Fig 1). A right brachial arteriogram showed no abnormalities. Pneumoencephalography was attempted twice, but no air could be driven into the ventricular system (Fig 2). The patient was obese, normotensive, and without visual field defects. Galactorrhea could not be demonstrated. Serum thyroxine level