Denise Hewson writes: I would
>appreciate any assistance with the following: I have a patient that is
>breastfeeding a 7 week old infant and would like to continue nursing for at
>least a year. This patient has lupus and was told by her rhuematologist that
>it was not a good idea to breastfeed .  She said it had something to do with
>the effects of prolactin on her body. I have tried to find info on this, but
>have not found anything to support his statement. I would appreciate any and
>all help!! Please e- mail me at [log in to unmask] Thank you D Hewson RN IBCLC


Hi Denise.  I did a Medline search on prolactin and lupus for 1991-1995, and
here's what I found (I omitted most of the ones on mice and men):

1.  Moncayo, R. and H.E. Moncayo  1995
        A new endocrinological and immunological syndrome in SLE: elevation
of human chorionic gonadotropin and of antibodies directed against ovary and
endometrium antigens.  Lupus 4(1):39-45.

Relevant parts of the abstract include "Endometrial antibodies were
significantly correlated to the levels of prolactin."

2.  Walker, S.E., et al.  1995
        Prolactin: a stimulator of disease activity in systemic lupus
erythematosus [review].  Lupus 4(1):3-9.

This is a review article about the whole relationship between the two.
Abstract not provided by Medline.

3.  Blank, M. et al.  1995
        Bromocriptine immunomodulation of experimental SLE and primary
antiphospholipid syndrome via induction of nonspecific T suppressor cells.
Cellular Immunology 162(1):114-122.

Abstract very jargonish, but apparently bromocriptine really helps reduce
the autoimmune antibody response of SLE, and is it thought to do so by
suppressing prolactin secretion by the pituitary.

4.  Pauzner, R. et al.  1994
        Prolactin in systemic lupus erythamatosus.  Journal of Rheumatology
21(11):2064-2067.

Abstract reproduced in full:  "Objective: To estimate the prevalence and
evaluate the clinical significance of hyperprolactinemia in a cohort of 82
consecutively reviewed patients with systemic lupus erythamatosus (SLE).
Methods: Basal prolactin levels and clinical data were analyzed in 82
consecutive patients with SLE, and longitudinal studies were carried out in
30/82 patients.  Results: Hyperprolactinemia was NOT associated with active
disease in the group as a whole (p=0.145) or in longitudinal studies in 30
patients (p=0.294).  However, SLE was more often active in patients with
hyperprolactinemia without any obvious causes (8/9 samples) compared with
patients with known secondary causes for hyperprolactinemia (p=0.088).
Conclusion: Hyperprolactinemia is likely NOT associated with disease
activity in SLE."

Caution: I wonder if *any* of their hyperprolactinemia patients with "known
secondary causes" were breastfeeding?

5.  Munoz, J.A.  1994
        Sex hormones in systemic lupus erythamatosus.  Correlation with
clinical and biological parameters.  Annales de Medecine Interne 147(7):459-463.

Found that steroid treatment lowered levels of prolactin, and said therefore
may be "an important contributing factor in immunomodulation of SLE".

I don't know how to interpret that.

6.  McMurray, R. et al.  1994
        Hyperprolactinemia in male NZB/NZW (B/W) F1 mice: accelerated
autoimmune disease with normal circulating testosterone.  Clinical
Immunology and Immunopathology 71(3):338-343.

Abstract reproduced in shortened form:  "It has been proposed that the
immunostimulatory hormone, prolactin, is associated with flares of systemic
lupus erythamatosus (SLE).  [note: this is a study in a mouse model].
Hyperprolactinemia accelerated mortality with vasculitis and renal disease
compared to control mice [not hyperprolactinemic].  The deleterious effects
of prolactin were not mediated through suppression of the immunoprotective
hormone, testosterone.  This observation supports the proposed association
between elevated prolactin levels and exacerbations of SLE."

7.  McMurray, R. et al.  1993
        Effects of parturition, suckling, and pseudopregnancy on variables
of disease activity in the B/W mouse model of systemic lupus erythamatosus.
Journal of Rheumatology 20(7):1095-1100.

8.  Jara, L.J., et al.  1992
        Does prolactin have a role in the pathogenesis of systemic lupus
erythamatosus.  Journal of Rheumatology 19(9):1333-1336.  Editorial.  Not
abstracted.

9.  Jara, L.J. et al.  1992
        Hyperprolactinemia in systemic lupus erythamatosus: association with
disease activity.  Americal Journal of the Medical Sciences 303(4):222-226.

Part of abstract: "Elevated serum levels of prolactin (PRL greater than 20
ng/ml) were found in a subset of SLE patients.  In addition, a direct
correlation with clinical disease and serological (ANA) activity was also
found."

I assume they mean a positive correlation (higher PRL means more symptoms).

There are several others.  If you want me to mail you these abstracts,
Denise, just send me your snail mail address.  Since you're just in Houston,
you'll probably have them in 1-2 days.  Looks like prolactin, by stimulating
the mother's immune system (which normally makes her healthier while
breastfeeding????) also then causes problems for people with autoimmune
diseases like lupus.  Very sad situation.  Best of luck.


Kathy Dettwyler
[log in to unmask]
Queen of References