Interesting case study featuring prolactin as a trigger of MS
Posted Dec 16 2009 12:00am
Written by Hollie - from the Accelerated Cure Project
If you, like me, watch the TV show "House," you'll be familiar with the concept that tumors in the body can over-secrete all kinds of substances which can cause baffling symptoms (baffling to the doctors on "House," anyway!). Here's a very interesting case study of that exact phenomenon in a man diagnosed with MS. (This link should lead to an open-access copy if you'd like to read the article for yourself.)
As the case study describes, the man went to the doctor at age 32 with symptoms of optic neuritis and leg weakness. MRI imaging revealed demyelinating lesions as well as a tumor on his pituitary gland (an adenoma) that was secreting excess prolactin. Prolactin is a hormone that stimulates the production of breast milk, but it can also have strong effects on the immune system (both stimulatory and inhibitory effects depending on other factors). CSF testing also revealed the presence of oligoclonal bands, a strong diagnostic marker of MS. The man's tumor was removed and he remained MS symptom-free and prolactin-normal for the next 12 years. Then the tumor came back, his prolactin levels rose, and he simultaneously developed new MS symptoms and MRI lesions. The man is now being treated with a prolactin-lowering drug, and has been in remission apart from one breakthrough episode of high prolactin levels and new MS lesions.
Although suppressing prolactin in this man correlated with suppression of his MS activity as well, it's hard to generalize this example to others with MS. Interestingly, prolactin levels in pregnant women reach levels that are many times higher than reported in this case study, and pregnancy and breastfeeding are both associated with lower relapse rates in women with MS. Furthermore, case-control studies have not found significantly higher levels of prolactin in people with MS. Still, unusual cases like this can sometimes be very informative -- so understanding why prolactin seems to be such a strong MS trigger in this man could lead to new insights about MS.