Multiple sclerosis (MS) is a disease of relapsing neurologic symptoms with phases of chronic progression. It is a T-cell mediated autoimmune disease. Typical changes of MS are seen in the brain on magnetic resonance imaging (MRI) brain scans. There is some genetic susceptibility for the disease.
MS has increased incidence in women. There is evidence for a role of hormones in this disease, especially for prolactin. One study showed increased prolactin levels (hyperprolactinemia or hyperprolactinaemia) in 30% of MS patients studied.
The authors followed a case of a 32 year old male who had three attacks of MS due to a prolactin secreting adenoma tumor of the pituitary gland. He started with loss of vision of one eye (optic neuritis) and weakness of the right leg in March, 1996. He was diagnosed as having a pituitary adenoma and the typical appearance of MS on the MRI scan. His serum prolactin level was 38 ng/ml (normal is 3.5-15.5.) The tumor was removed, surgically.
The patient did well for 12 years. In January, 2008, he developed trouble speaking and leg weakness. He was found to have recurrence of the tumor and MS by MRI and was given medications. This was worse in April, 2008, and the serum prolactin level was 36. He was given cabergoline with reduction of his prolactin level. With continued treatment with medication, his prolactin level stayed low and he had no more MS attacks.
CONCLUSION: The authors report the case of a man with recurrent MS attacks which seemed to be related to the prolactin production by a prolactinoma. The use of a pharmaceutical lowered his prolactin levels and no further MS attacks were seen.
NOTE: Prolactin elevation is considered to be a marker of autoimmune disease. Dopamine agonists, such as Vitex agnus casti, phenylalanine, and tyrosine, have been shown to reduce prolactin levels and shrink prolactinomas. Read about l-deprenyl, monamine oxidase and prolactin levels. Read about coeliac disease, psychiatric symptoms and prolactin levels.
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