RESEARCH PAPER
Hyperprolactinemia diagnostics – dilemmas over optimal selection of prolactinemia time points
1
Department of Endocrinology and Metabolic Diseases, Polish Mothers’ Memorial Hospital – Research Institute, Lodz, Poland
Ann Agric Environ Med. 2015;22(2):332-337
KEYWORDS
ABSTRACT
Introduction:
Laboratory discrimination of pathologic hyperprolactinemia is an important step in the diagnosis of pathology influencing overall health and fertility. A major issue is the choice of time and circumstances for obtaining a blood sample for prolactin assay that would be representative for mean daily plasma concentration of a subject.
Objectives:
The aim of the study was a comparison of reliability of single prolactin assessment on various time-points in a day with circadian prolactinemia profile in order to find the easiest, the least expensive, and the most reliable method of hyperprolactinemia diagnosis.
Material and Methods:
The study was a retrospective analysis of 138 women, hospitalized in the Department of Endocrinology and Metabolic Diseases, Polish Mother`s Memorial Hospital – Research Institute, Lodz, Poland, in whom the circadian profile of prolactin (including assays at 8.00 am, 11.00 am, 2.00 pm, 5.00 pm, 8.00 pm, 11.00 pm, 2.00 am, 5.00 am and repeatedly at 8.00 am) had been assessed.
Results:
On the basis of AUC (area under the curve) of prolactin concentrations, hyperprolactinemia was diagnosed in 34 subjects (24.6 % of the entire group). The attempts to diagnose hyperprolactinemia based on a single prolactin assay failed due to a high percentage of false negative and false positive results. Only significant hyperprolactinemia with mean prolactin concentration of about 100 µg/l or more appeared easy to diagnose. Combinations of several time points also appeared not reliable enough.
Conclusions:
The nine-point daily profile of prolactinemia in any patient with clinical suspicion of hyperprolactinemia seems the best mode for estimating mean circadian prolactin concentration.
Laboratory discrimination of pathologic hyperprolactinemia is an important step in the diagnosis of pathology influencing overall health and fertility. A major issue is the choice of time and circumstances for obtaining a blood sample for prolactin assay that would be representative for mean daily plasma concentration of a subject.
Objectives:
The aim of the study was a comparison of reliability of single prolactin assessment on various time-points in a day with circadian prolactinemia profile in order to find the easiest, the least expensive, and the most reliable method of hyperprolactinemia diagnosis.
Material and Methods:
The study was a retrospective analysis of 138 women, hospitalized in the Department of Endocrinology and Metabolic Diseases, Polish Mother`s Memorial Hospital – Research Institute, Lodz, Poland, in whom the circadian profile of prolactin (including assays at 8.00 am, 11.00 am, 2.00 pm, 5.00 pm, 8.00 pm, 11.00 pm, 2.00 am, 5.00 am and repeatedly at 8.00 am) had been assessed.
Results:
On the basis of AUC (area under the curve) of prolactin concentrations, hyperprolactinemia was diagnosed in 34 subjects (24.6 % of the entire group). The attempts to diagnose hyperprolactinemia based on a single prolactin assay failed due to a high percentage of false negative and false positive results. Only significant hyperprolactinemia with mean prolactin concentration of about 100 µg/l or more appeared easy to diagnose. Combinations of several time points also appeared not reliable enough.
Conclusions:
The nine-point daily profile of prolactinemia in any patient with clinical suspicion of hyperprolactinemia seems the best mode for estimating mean circadian prolactin concentration.
REFERENCES (24)
1.
Melmed S, Casanueva FF, Hoffman AR, Kleinberg DL, Montori VM, Schlechte JA, et al. Diagnosis and treatment of hyperprolactinemia: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab. 2011; 96(2): 273–288.
2.
Karasek M, Pawlikowski M, Lewiński A. Hiperprolaktynemia: przyczyny, diagnostyka, leczenie. Endokrynol Pol. 2006; 57(6): 656–662 (in Polish).
3.
Lee DY, Oh YK, Yoon BK, Choi D. Prevalence of hyperprolactinemia in adolescents and young women with menstruation-related problems. Am J Obstet Gynecol. 2012; 206: 213.e1–5.
4.
Prabhakar VKB, Davis JRE. Hyperprolactinaemia. Best Pract Res Clin Obstet Gynaecol. 2008; 22: 341–353.
5.
Jezkova J. Marek J. Diagnosis and treatment of prolactinomas. Expert Rev Endocrinol Metab. 2009; 4(2): 135–142.
6.
Stawerska R, Smyczynska J, Hilczer M, Lewinski A, Karasek M. High repeatability of circadian prolactin rhythm assessment results in children. Neuroendocrinol Lett. 2008; 29(6): 889–894.
7.
Nassiri F, Cusimano MD, Scheithauer BW, Rotondo F, Fazio A, Syro LV, et al. Prolactinomas: diagnosis and treatment. Expert Rev Endocrinol Metab. 2012; 7(2): 233–241.
8.
Alpañés M, Sanchón R, Martínez-García MA, Martínez-Bermejo E, Escobar-Morreale HF. Prevalence of hyperprolactinaemia in female premenopausal blood donors. Clin Endocrinol (Oxf). 2013; 79(4): 545–549.
10.
Zgliczynski W, Zdunowski P. Hyperprolactinaemia – pitfalls in PRL assessment. Pol J Endocrinol. 2005; 56(6): 980–985.
12.
Casanueva FF, Molitch ME, Schlechte JA, Abs R, Bonert V, Bronstein MD, et al. Guidelines of the Pituitary Society for the diagnosis and management of prolactinomas. Clin Endocrinol (Oxf). 2006; 65(2): 265–273.
13.
Lennartsson AK, Jonsdottir IH. Prolactin in response to acute psychosocial stress in healthy men and women. Psychoneuroendocrinology 2011; 36: 1530–1539.
14.
Kruger TH, Leeners B, Naegeli E, Schmidlin S, Schedlowski M, Hartmann U, et al. Prolactin secretory rhythm in women: immediate and long-term alterations after sexual contact. Hum Reprod. 2012; 27(4): 1139–1143.
15.
Newey PJ1, Gorvin CM, Cleland SJ, Willberg CB, Bridge M, et al. Mutant prolactin receptor and familial hyperprolactinemia. New Engl J Med. 2013; 369(21): 2012–2020.
16.
Lewandowski KC, Skowronska-Jozwiak E, Szosland K, Lewinski A. Effect of timing of prolactin sampling on the incidence of spurious hyperprolactinaemia. Endocrine Abstracts 2005; 9: 223.
17.
Roelfsema F, Pijl H, Keenan DM, Veldhuis JD. Prolactin secretion in healthy adults is determined by gender, age and body mass index. PLoS One. 2012; 7(2): e31305.
18.
Kok P, Roelfsema F, Langendonk JG, de Wit CC, Frölich M, Burggraaf J, et al. Increased circadian prolactin release is blunted after body weight loss in obese premenopausal women. Am J Physiol Endocrinol Metab. 2006; 290: E218-E224.
19.
Jiang XB, Li CL, He DS, Mao ZG, Liu DH, Fan X, et al. Increased carotid intima media thickness is associated with prolactin levels in subjects with untreated prolactinoma: a pilot study. Pituitary 2014; 17: 232–239.
20.
Serri O, Chik CL, Ur E, Ezzat S. Diagnosis and management of hyperprolactinemia. CMAJ 2003; 169(6): 575–581.
21.
Ryszka F, Klimas R, Dolinska B, Lopata K. Influence of prolactin and calcium gluconate concentration on permeation and intestinal absorption of Ca(II) ions. Protein Pept Lett. 2012; 19(8): 804–807.
22.
Kostrzak A, Warenik-Szymankiewicz A, Męczekalski B. The role of serum PRL bioactivity evaluation in hyperprolactinaemic women with different menstrual disorders. Gynecol Endocrinol. 2009; 25(12): 799–806.
23.
Isik S, Berker D, Tutuncu YA, Ozuguz U, Gokay F, Erden G, et al. Clinical and radiological findings in macroprolactinemia. Endocrine 2012; 41: 327–333.
24.
Lewandowski KC, Gasior-Perczak D, Kowalska A, Lewiński A. Coexistence of macroprolactinaemia and hyperprolactinaemia in women with oligo-/amenorrhoea is associated with high risk of pituitary adenomas. Gynecol Endocrinol. 2014; 30(5): 385–387.
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