High prolactin levels may be missed by immunoradiometric assay in patients with macroprolactinomas

St-Jean, Edith; Blain, François; Comtois, Ronald

doi:10.1046/j.1365-2265.1996.663486.x

Cited by 126 publications

(56 citation statements)

References 16 publications

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“…However, the use of immunoradiometric assay in the measurement of serum prolactin concentrations might result in falsely low values because of the 'hook' effect (St-Jean et al 1996). This phenomenon is reported primarily in patients with giant prolactinomas where initial measurements of serum prolactin concentration were reported to be only mildly increased (50-150 µg/l).…”

Section: Clinical Manifestations and Diagnosis Of Prolactinomasmentioning

confidence: 93%

Pituitary tumors: pathophysiology, clinical manifestations and management.

Arafah¹,

Nasrallah²

2001

Endocrine-Related Cancer

185

141

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Pituitary tumors are frequently encountered intracranial neoplasms. They present with a variety of clinical manifestations that include symptoms and signs of excessive hormone secretion by the tumor, signs of hormone deficits by the normal pituitary gland and others related to expansion of the tumor mass and the resulting compression of surrounding structures such as the optic chiasm and cranial nerves. Advances in molecular biology, immunocytochemical staining and imaging, and the introduction of new treatment options have improved our understanding of the natural history of these adenomas and their management. Available treatments include surgical, medical and radiation therapy. Although the primary treatment for each tumor type may vary, it is important to consider all available options and select the most applicable for that patient. The interaction of all members of management team, including the primary care provider, the endocrinologist and the neurosurgeon in selecting the treatment course can only improve therapeutic outcome. Regardless of the initial choice of treatment, follow-up of all patients should be maintained indefinitely. The managing physician should be familiar with the natural history and long-term complications of pituitary adenomas, and with the side effects of treatments given over the years.

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Section: Clinical Manifestations and Diagnosis Of Prolactinomasmentioning

confidence: 93%

Pituitary tumors: pathophysiology, clinical manifestations and management.

Arafah¹,

Nasrallah²

2001

Endocrine-Related Cancer

185

141

View full text Add to dashboard Cite

show abstract

“…It may therefore be excessively difficult to recognize a prolactinoma in such patients. In addition, if moderate hyperprolactinaemia is frequent in patients with non-secreting lesions because of pituitary stalk compression, it is advisable in patients with huge tumours to dilute plasma samples in order not to miss very high PRL concentrations, which may give rise to erroneously low values in two-site 'sandwich' assays (the so-called hook effect) (32).…”

Section: Peculiarity Of Bioclinical Endocrine Changes In the Elderlymentioning

confidence: 99%

Diagnosis and management of pituitary tumours in the elderly: a review based on personal experience and evidence of literature

Minniti

Esposito

Piccirilli³

et al. 2005

eur j endocrinol

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An increasing proportion of pituitary adenomas are recognized in the elderly, raising the question of their optimal diagnosis and management. Age-related endocrine changes and associated diseases may significantly modify the clinical presentation and hormonal evaluation of these patients. About 80% of pituitary adenomas in this age group are non-secreting, requiring careful differential diagnosis with non-adenomatous sellar lesions. In this group, visual deterioration and hypopituitarism remain the leading symptoms. Recognized secreting tumours are mainly GH-secreting, most of them intrasellar, followed by prolactinomas, which present as clinically non-secreting and are usually invasive. Cushing's disease appears as a very rare eventuality in the elderly. Optimal therapeutic management should aim to control the disease while preserving or improving patient's quality of life. Transsphenoidal surgery has proved to be an efficient and well-tolerated option for non-secreting adenomas with visual defects and intrasellar GH-secreting adenomas, being able to improve metabolic and cardiovascular complications of acromegaly even in this age group. In contrast, dopamine-agonist drugs can be proposed as a primary therapy for prolactinomas even in the presence of severe neurological complications. Because the use of radiotherapy is hampered by its delay of action and potential neurological side effects, its indications should be better defined in this age group. The clinical importance of hypopituitarism should not be underestimated, and thyroid-and adrenal-replacement therapy are mandatory in the presence of documented hormone deficiency, carefully avoiding overtreatment in order to limit possible side effects on the cardiovascular system and bone mineralization. Indications for GH-and sex steroid-replacement therapy still await age-specific guidelines.European Journal of Endocrinology 153 723-735

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“…In addition to hormonal assays, the high dose hook effect has also been demonstrated in immune-based techniques used in the measurements of CA 125, IgE and prostrate specific antigen. (Wolf,1989;St-Jean et al, 1996). All immunoassays are based on antigen antibody interactions.…”

Section: Discussionmentioning

confidence: 99%

Utility of One Step Immunoassay in Detecting False Negativity in Routine Blood Bank Screening of Infectious Diseases

Akhtar¹

2012

Trends in Immunolabelled and Related Techniques

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High prolactin levels may be missed by immunoradiometric assay in patients with macroprolactinomas

Cited by 126 publications

References 16 publications

Pituitary tumors: pathophysiology, clinical manifestations and management.

Pituitary tumors: pathophysiology, clinical manifestations and management.

Diagnosis and management of pituitary tumours in the elderly: a review based on personal experience and evidence of literature

Utility of One Step Immunoassay in Detecting False Negativity in Routine Blood Bank Screening of Infectious Diseases

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