Galactorrhea in an Adolescent Girl
Galactorrhea in an Adolescent Girl
DK presented for her 13-year well-child care (WCC) visit with a 3-month history of headaches and galactorrhea. During the review of systems, DK reported having had frequent headaches (2 to 3 per week) that were primarily frontal and were not accompanied by vision changes, numbness, tingling, nausea, or vomiting. They occurred sporadically without obvious patterns of onset or triggers and initially were easily relieved by rest and ibuprofen. Recently these headaches had become more severe and had not responded as readily to ibuprofen, causing DK to miss several days of school. DK also reported a 3-month history of bilateral white discharge from both of her nipples, with the discharge from the left side being more significant than that from the right side. DK denied sexual activity, trauma, or manipulation of her breasts. The remainder of DK's interval history and review of systems was benign except that she had not yet reached menarche. This was unusual, because 18 months earlier it had been noted that she was Tanner stage IV for both breast and pubic hair (PH).
DK presented for her 13-year well-child care (WCC) visit with a 3-month history of headaches and galactorrhea. During the review of systems, DK reported having had frequent headaches (2 to 3 per week) that were primarily frontal and were not accompanied by vision changes, numbness, tingling, nausea, or vomiting. They occurred sporadically without obvious patterns of onset or triggers and initially were easily relieved by rest and ibuprofen. Recently these headaches had become more severe and had not responded as readily to ibuprofen, causing DK to miss several days of school. DK also reported a 3-month history of bilateral white discharge from both of her nipples, with the discharge from the left side being more significant than that from the right side. DK denied sexual activity, trauma, or manipulation of her breasts. The remainder of DK's interval history and review of systems was benign except that she had not yet reached menarche. This was unusual, because 18 months earlier it had been noted that she was Tanner stage IV for both breast and pubic hair (PH).
