Emotionally induced galactorrhoea in a non-lactating female -"pseudo- lactation"?

Abstract

Background: Galactorrhoea is a common clinical problem in endocrinology. Visual and auditory cues from thenewborn are known to stimulate prolactin secretion in lactating women. However, hyperprolactinaemia andgalactorrhoea in a non-lactating female due to visual and auditory stimuli from an unrelated newborn has not beenreported in the past. We report the first such case of 'pseudo-lactation'.Case presentation: An 18-year-old girl with type 1 diabetes mellitus presented with galactorrhoea. Apparentlygalactorrhoea was preceded by seeing the baby, hearing her cries or when remembering her memories. Her menstrualcycles were normal and did not complain of any headache or visual disturbances. She was only on metformin andinsulin. Symptoms have rapidly resolved after the newborn was shifted to another location. Examination revealedscanty nipple discharge with gentle pressure. Investigations revealed an elevated serum prolactin of 62.5 ng/mL(2717.4 pmol/L) and fasting plasma glucose of 142 mg/dL (7.9 mmol/L) and HbA1c of 7.6%. Her thyroid functionwas normal and MRI at the time of galactorrhoea was not available. At 3 months prolactin was normal and MRIrevealed only a slight asymmetry of the pituitary without evidence of microadenoma.Conclusion: The strong temporal relationship between her symptoms and emotional attachment to the newbornwith exclusion of other causes on clinical, biochemical and radiological evidence, raise the possibility that transienthyperprolactinaemia was due to a transient lactotroph hyperplasia and hyper function which had been triggeredby the stimulatory cues from the newborn.Emotionally induced "pseudo lactation" may be a rare but important cause for transient hyperprolactinaemia in anon-lactating female.