Ends of the spectrum best practices for early detection and multidisciplinary management of acromegaly.

Purpose: Acromegaly is characterized by an insidious clinical presentation and delayed diagnosis. Longer delays are associated with more comorbidities which can persist after treatment of the growth hormone-secreting pituitary adenoma (GH-PA). Surgery is the primary therapy of GH-secreting PA, which can lead to durable remission.

Hypoprolactinemia, a neglected endocrine disorder.

This special issue of Reviews in Endocrine and Metabolic Disorders is dedicated to hypoprolactinemia. Prolactin is known for its actions on the mammary gland including development, preparation for postpartum lactation, as well as synthesis and maintenance of milk secretion. However, prolactin has many other physiological effects on reproduction, embryonic and fetal development, homeostasis, neuroprotection, behavior, and immunoregulation.

Isolated IgG4-related Infundibulo-hypophysitis.

A 72-year-old man presented with several months of weakness, poor appetite, and depressed moods. Laboratory tests indicated central hypocortisolism, hypothyroidism and hypogonadism, and mild hyperprolactinemia. Imaging indicated a homogenously enhancing solid suprasellar mass inseparable from the hypothalamus and contiguous with a thickened proximal infundibulum.

Drug induced hypoprolactinemia.

Prolactin levels can be influenced by multiple medications primarily through the interaction with dopamine receptors which regulate its secretion. Unlike hyperprolactinemia which has a well-defined clinical phenotype, the effects of hypoprolactinemia beyond inability to lactate are incompletely understood. Recent studies have raised concerns regarding detrimental changes in glucose metabolism, sexual function and psychological profile in patients with low prolactin levels.