Regarding possible mechanisms, mild hyperprolactinemia was noted, with normal biologically active prolactin, and the elevated total prolactin is likely due to macroprolactin, though technically in the indeterminate zone. This may reflect transient HPA dysfunction, potentially secondary to subtle hypothalamic dysregulation or stalk effect, possibly related to mild immune or inflammatory processes not evident on imaging, as has been suggested in other cases of functional pituitary impairment [2,17]. Here, PRL is linked to hyperprolactinemia.