Hi Fiona
A prolactinoma looks to be the cause
Have you done a macroprolactin to see if the elevation is high molecular weight ?
Any other pituitary investigations for micro or macro prolactin secreting tumours ?
Any effects on the visual from the pituitary enlargement ?
Cheers
Paul
-----Original Message-----
From: Clinical biochemistry discussion list [mailto:[log in to unmask]] On Behalf Of Fiona Davidson
Sent: Wednesday, 16 April 2014 2:32 AM
To: [log in to unmask]
Subject: Interpretation of male gonadotrophins with normal testosterone
Dear all,
We have recently had a coupleof slightly odd male LH and FSH results in the context of erectile dysfunction with normal total testosterone. I was wonder if the collective brain could share their thoughts on how to interpret gonadotrophin results in the absence of obvious primary or secondary hypogonadism?
Patient 1:
44 y/o presenting with erectile dysfunction and prev history of epilepsy (not clear what, if any current medication he is on).
Total Testosterone = 22.7 nmol/L
FSH = 31 IU/L
LH = 28 IU/L
Prolactin = 135 mU/L
UE, LFTs, Lipids all normal. Above results were confirmed on repeat.
Could this be due to anti-epileptic medication?
Patient 2:
27 y/o presenting with low libido and erectile dysfunction and concerned RE fertility. Not on any medication or supplements.
Total Testosterone = 15.3
FSH = < 1
LH = 3
Prolactin = 239
Oestradiol < 100
All results confirmed on repeat.
Normal UE, LFT, lipids.
SHBG was not measured for either of these patients as the testosterone was well into the normal range in both cases.
All comments gratefully received!
Kind Regards
Fiona Davidson
Senior Clinical Biochemist
Kingston Hospital
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------ACB discussion List Information--------
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Please note, archived messages are public and can be viewed via the internet. Views expressed are those of the individual and they are responsible for all message content.
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