Étiologies des Hyperprolactinémies au Niger

RESUME Introduction. L’hyperprolactinemie represente une secretion supra physiologique de la prolactine. C’est en pratique clinique le desordre hypophysaire anterieur le plus frequemment rencontre. Toutefois, sa prevalence reelle est peu connue en Afrique. Le but de cette etude etait d’identifier les principales etiologies des hyperprolactinemies au Niger. Methodologie. Il s’agit d’une etude transversale descriptive ayant permis de colliger les patients venus en consultation dans le service de medecine interne ou a la clinique magori du 1erjanvier 2016 au 30 juin 2017(soit 18 mois) pour hyperprolactinemie. Etaient inclus les patients suivis ou dont le diagnostic de l hyperprolactinemie a ete etabli en consultation endocrinologique durant la periode de’ etude. Resultats. Cette etude a permis d’enregistrer 38 cas d’hyperprolactinemie. Le sexe feminin representait 81,57%( sex ratio H/F 0,18) et l’âge moyen etait de 33,5 ans. La tranche d’âge 21-30 ans etait la plus representee avec 42,10%. Chez les femmes, l’amenorrhee-galactorrhee representait 74% des tableaux cliniques et l’infertilite 41,93%. Chez les hommes, l’infertilite representait 57,14% des presentations, les cephalees 42,85% et les troubles de l’erection 42,85%. La duree d’evolution des signes etait comprise entre 0-24 mois chez 60,52% des patients. La prolactinemie moyenne etait de 166,18 ng/ml. La TDM a ete realisee chez 31,6% des patients. Les principales etiologies etaient les medicaments (28,94%), les adenomes hypophysaires (21,05%) et les tumeurs ovariennes (13,15%). Parmi les medicaments, la cimetidine et la contraception a base d’œstrogene representaient 10,52% des etiologies chacune. Tous nos patients ont ete traites par agonistes dopaminergiques. La cabergoline a ete prescrit chez 65,80% des patients. L’evolution a ete favorable chez 89,47% des patients. Conclusion. l’hyperprolactinemie est une pathologie qui existe dans nos regions. La principale etiologie demeure les medicaments dont en tete la cimetidine et les oestrooprogestatifs. ABSTRACT Introduction. Hyperprolactinemia is a supra-physiologic secretion of prolactin.  In clinical practice, it is the most frequently encountered anterior pituitary disorder. Its prevalence is undefined in Africa. The purpose of this study was to identify the main etiologies of hyperprolactinemia in Niger. Methodology. This was a descriptive cross-sectional study that made it possible to collect the patients who came for consultation in the department of internal medicine or the Magori Clinic from January 1, 2016 to June 30, 2017 (18 months) for hyperprolactinemia. Patients followed or whose diagnosis of hyperprolactinemia was established during the study period were included. Results. We recorded 38 cases of hyperprolactinemia. The female sex represented 81.57% (sex ratio H / F 0.18) and an average age of 33.5 years. The 21-30 age group was the most represented with 42.10%. In women, amenorrhea-galactorrhea accounted for 74%, infertility 41.93%. In men, infertility accounted for 57.14%, headache 42.85% and erectile dysfunction 42.85%. The duration of the disease was between 0-24 months in 60.52% of patients. The average prolactin level was 166.18 ng / ml (extreme). CT was performed in 31.6% of patients. The main etiologies were drugs (28.94%), pituitary adenomas (21.05%), ovarian tumors (13.15%). Concerning drugs, cimetidine and estrogen-based contraception accounted for 10.52% each. All patients were treated with dopamine agonists. Cabergoline was prescribed in 65.80% of patients. The evolution was favorable for 89.47% of the patients. Conclusion. Hyperprolactinemia is a reality in Niger. Cimetidine and oestrooprogestatives are the most common etiologies.