Recurrent Hyperprolactinemia and Neuro-Endocrine Decompensation Following Self-Discontinuation of Cabergoline in a Patient with Partial Empty Sella Syndrome: A Case Report

Research Article | Open Access

Volume 2026 - 5 | Article ID 316 | https://dx.doi.org/10.51521/IJMCCR.2026.e5-1-116

Recurrent Hyperprolactinemia and Neuro-Endocrine Decompensation Following Self-Discontinuation of Cabergoline in a Patient with Partial Empty Sella Syndrome: A Case Report

Academic Editor: John Bose

Received 2026-08-30
Revised 2026-09-25
Accepted 2026-10-05
Published 2026-10-08

Abdirizak Hussein Barre

Abdirizak Hussein Barre, MBBS, Mmed Neurology, Neurologist Doctor, Halab Hospital, Somalia, Email: abdirizak@alumni.siu.edu.so.

Corresponding Author: Abdirizak Hussein Barre, MBBS, Mmed Neurology, Neurologist Doctor, Halab Hospital, Somalia, Email: abdirizak@alumni.siu.edu.so

Citation: Abdirizak Hussein Barre, (2026) Recurrent Hyperprolactinemia and Neuro-Endocrine Decompensation Following Self-Discontinuation of Cabergoline in a Patient with Partial Empty Sella Syndrome: A Case Report. Int J Med Clin Case Rep, 2026,5(1), 1-5.

Copyright: © 2026 Abdirizak Hussein Barre., This is an open-access article distributed under the terms of the Creative Commons Attribution 4.0 International License, which permits unrestricted use, distribution and reproduction in any medium, provided the original author and source are credited.

Abstract:

Background: Partial empty sella syndrome (PESS) is frequently associated with underlying pituitary pathology, including prolactinoma, and can present with a broad spectrum of neurological and endocrine manifestations, Abrupt discontinuation of dopamine agonist therapy in patients with prolactin-secreting adenomas can precipitate rapid biochemical and clinical relapse.

Case Presentation: We report the case of a 56-year-old male with a 13-year history of pituitary gland enlargement, previously biochemically controlled on cabergoline, who presented with a one-month history of progressive headache, dizziness, fatigue, sleep disturbance, gynecomastia, nipple swelling, and reduced libido following self-discontinuation of cabergoline. Laboratory evaluation confirmed a rise in prolactin from 3.65 ng/mL (on therapy) to 19.57 ng/mL (off therapy), alongside newly identified hyperglycemia (HbA1c 8.5%) and hypertension. MRI of the brain/pituitary demonstrated a moderate-grade (Grade III) partial empty sella. The patient was restarted on cabergoline and referred for comprehensive endocrine evaluation.

Conclusion: this case highlights the risk of clinical and biochemical relapse following non-adherence to dopamine agonist therapy in patients with prolactin-related pituitary disease, and underscores the importance of multidisciplinary management encompassing endocrinology, neurology, psychological support, and cardiometabolic risk reduction.

Keywords: Partial Empty Sella Syndrome, Hyperprolactinemia, Cabergoline, Gynecomastia, Pituitary Adenoma, Medication Non-Adherence.