galactorrhea

乳汁漏出症

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出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2015/02/09 16:29:23」(JST)

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Galactorrhea
Classification and external resources
ICD-10	N64.3, O92.6
ICD-9	611.6, 676.6
DiseasesDB	6314
Patient UK	Galactorrhea
MeSH	D005687

Galactorrhea (also spelled galactorrhoea) (galacto- + -rrhea) or lactorrhea (lacto- + -rrhea) is the spontaneous flow of milk from the breast, unassociated with childbirth or nursing.

Galactorrhea is reported to occur in 5%-32% percent of women. Much of the difference in reported incidence can be attributed to different definitions of galactorrhea. Although frequently benign, it may be caused by serious underlying conditions and should be properly investigated. Galactorrhea also occurs in males, newborn infants and adolescents of both sexes.

Causes

It can be due to dysregulation of certain hormones or local causes such as excessive nipple stimulation. Hormonal causes most frequently associated with galactorrhea are hyperprolactinemia and thyroid conditions with elevated levels of TSH or TRH hormones. No obvious cause is found in about 50% of cases.

Lactation requires the presence of estrogen, progesterone and prolactin, and the evaluation of galactorrhea includes eliciting a history for various medications or foods (methyldopa, opiates, antipsychotics, serotonin reuptake inhibitors, as well as licorice) and for behavioral causes (stress, and breast and chest wall stimulation), as well as evaluation for pregnancy, pituitary adenomas (with overproduction of prolactin or compression of the pituitary stalk), and hypothyroidism. Adenomas of the anterior pituitary are most often prolactinomas. Overproduction of prolactin leads to cessation of menstrual periods and infertility, which may be a diagnostic clue. Galactorrhea may also be caused by hormonal imbalances owing to birth control pills.

Galactorrhea is also a side effect associated with the use of the second-generation H2 receptor antagonist Cimetidine (trade name: Tagamet). Galactorrhea can also be caused by anti-psychotics that cause hyperprolactinemia by blocking dopamine receptors responsible for control of prolactin release. Of these, risperidone is the most notorious for causing this complication. Case reports suggest proton-pump inhibitors have been shown to cause Galactorrhea.

Neonatal milk

Main article: witch's milk

Neonatal milk or witch's milk is milk secreted from the breasts of many newborn infants. It is considered a normal variation and no treatment or testing is necessary. In folklore, witch's milk was believed to be a source of nourishment for witches' familiar spirits.

See also

• Galactagogue, a substance that promotes lactation in humans and animals

References

External links

• familydoctor.org has a good overview of galactorrhea.
• http://www.calgaryhealthregion.ca/breasthealth/common_breast_conditions/gynecomastia_male.htm
• MR images Galactorrhea and Pituitary tumors (microadenoma)

UpToDate Contents

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• 1. 乳頭分泌 nipple discharge
• 2. 高プロラクチン血症の臨床症状および診断 clinical manifestations and diagnosis of hyperprolactinemia
• 3. 高プロラクチン血症の原因 causes of hyperprolactinemia
• 4. 小児および思春期における乳房疾患の概要 overview of breast disorders in children and adolescents
• 5. 女性における双極性障害：避妊、妊娠前評価およびカウンセリング bipolar disorder in women contraception and preconception assessment and counseling

English Journal

• Acute lymphoblastic leukaemia presenting with galactorrhoea.

• See WS, Cheuk DK, Fung KL, Chan GC.SourceDepartment of Paediatrics & Adolescent Medicine, The University of Hong Kong, Hong Kong, Hong Kong.
• BMJ case reports.BMJ Case Rep.2013 Jan 2;2013. pii: bcr2012007461. doi: 10.1136/bcr-2012-007461.
• A teenage girl presented with galactorrhoea and moderate hyperprolactinaemia. She was subsequently diagnosed to have acute lymphoblastic leukaemia. Further investigations supported the presence of ectopic prolactin production as suggested by the presence of prolactin mRNA in the patient's marrow at
• PMID 23283609

• Primary pituitary abscess with coexisting pyogenic meningitis: an unexpected diagnosis.

• Bangera S, Chattopadhyay, Singh RK, Al Asousi AA, Joseph E.SourceInternal Medicine Unit (SB, RKS, AAAA), Endocrinology Unit (AC), and Pathology Unit (EJ), Department of Medicine, Al Sabah Hospital, Ministry of Health, Kuwait.
• The American journal of the medical sciences.Am J Med Sci.2013 Jan;345(1):75-7. doi: 10.1097/MAJ.0b013e318265a10c.
• ABSTRACT:: Primary pituitary abscess is a very rare disease most likely associated with pyogenic infection. A 27-year-old woman was initially diagnosed and treated as a case of acute pyogenic meningitis. In view of persistent headache, impaired visual fields, galactorrhea and menstrual irregularitie
• PMID 23262813

• Multicystic ovaries and pituitary pseudo-adenoma associated with primary hypothyroidism.

• Katulande P, Kariyawasam SS, Senanayake HM, Weerakkodi M.SourceDepartments of General Medicine.
• Journal of obstetrics and gynaecology : the journal of the Institute of Obstetrics and Gynaecology.J Obstet Gynaecol.2013 Jan;33(1):17-9. doi: 10.3109/01443615.2011.565388.
• Ovarian hyperstimulation syndrome (OHSS) is a well known but poorly understood iatrogenic complication of superovulation. Spontaneous OHSS has been reported with pregnancy, polycystic ovary syndrome, primary hypothyroidism and pituitary adenoma. Only a few cases of massive ovarian enlargement in non
• PMID 23259871

Japanese Journal

• 臨床研究・症例報告 頭痛と乳汁分泌を契機に発見されたRathke嚢胞とプロラクチン産生下垂体腺腫合併の女児例--既知報告例と文献的考察

• 大西 周子,鈴木 順造,野沢 ルリ子 [他]
• 小児科臨床 64(2), 311-316, 2011-02
• NAID 40017431947

• (2)乳汁漏出性無月経(2)月経異常を伴う内分泌疾患,3.内分泌疾患,E.婦人科疾患の診断・治療・管理,研修コーナー)

• 千石 一雄
• 日本産科婦人科學會雜誌 61(1), "N-15"-"N-21", 2009-01-01
• NAID 110007027329

Related Links

• galactorrhea - definition of galactorrhea in the Medical ...

Galactorrhea Definition Galactorrhea is the secretion of breast milk in men, or in women who are not breastfeeding an infant. Description Lactation, or the production of breast milk, is a normal condition occurring in women after ...

• Galactorrhea - Department of Medicine

Galactorrhea is a discharge of milk-like substance from the breast that is not associated with breastfeeding after pregnancy. This condition mainly occurs in women. It does occur in men, but much less commonly. The milky white ...

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リンク元	「乳汁漏出症」「溢乳」
拡張検索	「amenorrhea-galactorrhea syndromes」「galactorrhea-amenorrhea syndrome」「amenorrhea-galactorrhea syndrome」

「乳汁漏出症」

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英

galactorrhea

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乳漏症 lactorrhea

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溢乳、乳汁漏出、乳汁漏出・無月経症候群

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乳汁漏出症 : 約 58,800 件
乳漏症 : 約 19,900 件

「溢乳」

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英

galactorrhea

関

乳汁漏出、乳汁漏出症

「amenorrhea-galactorrhea syndromes」

　　[★] 乳汁漏出・無月経症候群。無月経・乳汁漏出症候群

「galactorrhea-amenorrhea syndrome」

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乳汁分泌・無月経症候群

「amenorrhea-galactorrhea syndrome」

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乳汁漏出無月経症候群