This protocol applies to patients with hyperprolactinaemia arising from a pituitary adenoma that co-occurs with excess growth hormone (GH) secretion — specifically, autonomous GH secretion with an elevated serum insulin-like growth factor 1 (IGF-1). This combination represents a distinct clinical situation that warrants a specific therapeutic approach.
When hyperprolactinaemia occurs alongside a pituitary adenoma with demonstrated autonomous GH secretion, standard prolactinoma management is insufficient. The presence of excess GH secretion fundamentally alters the treatment strategy and requires a different therapeutic approach directed by established acromegaly guidelines.
Management in this setting follows current acromegaly guidelines. Monitoring of serum IGF-1 during follow-up is central to ongoing assessment — a rise in IGF-1 above the upper limit of normal triggers a specific clinical decision point. The complete structured algorithm, including full sequencing and criteria, is available in the protocol below.
DOI: 10.1038/s41574-023-00886-5