Serial prolactin sampling as a confirmatory test for true hyperprolactinemia

Francés, Carla; Boix, E.; Fajardo, Maria Teresa M.; Gómez-García, José Manuel

doi:10.1016/j.endinu.2019.11.006

Cited by 6 publications

(6 citation statements)

References 8 publications

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“…Our data is consistent with previous studies documenting a wide prevalence of stress-induced hyperprolactinaemia, ranging from 27% to 68%, using the cannulated prolactin test in both males and females with mild hyperprolactinamia. 2,5,6 Our findings are consistent with a more recent study of 93 patients with referral prolactin concentration of <4 × ULN whereby a 54% prevalence of stress hyperprolactinaemia on cannulated serial prolactin testing was found. 7 Abbreviations: SD: standard deviation of mean.…”

supporting

confidence: 91%

Value of cannulated prolactin testing in identifying true hyperprolactinaemia in females of reproductive age

Tee,

Gad,

Boot

et al. 2024

Clinical Endocrinology

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supporting

confidence: 91%

Value of cannulated prolactin testing in identifying true hyperprolactinaemia in females of reproductive age

Tee,

Gad,

Boot

et al. 2024

Clinical Endocrinology

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“…9 A study of 66 (92% female) patients, with sampling over 30 min, reported a normal prolactin result in 45 (68%) patients; however, it did not specifically report the number of patients for whom normalisation occurred on the 30-min (as opposed to initial) sample. 10 Our data add to the existing literature by suggesting that a relatively short rest period of 20-40 min is sufficient to identify patients where initial hyperprolactinaemia is attributable to venepuncture stress (consistent with the described half-life of prolactin 4 ), and by specifically clarifying that serial sampling appears to offer no advantage over a single, rested sample. Since obtaining multiple samples over 120 min is often impractical and labour-intensive, this has significant implications from a resource perspective.…”

Section: Discussionsupporting

confidence: 63%

“…A study of 53 (94% female) included 25 patients taking medication associated with hyperprolactinaemia and did not exclude macroprolactin interference 9 . A study of 66 (92% female) patients, with sampling over 30 min, reported a normal prolactin result in 45 (68%) patients; however, it did not specifically report the number of patients for whom normalisation occurred on the 30‐min (as opposed to initial) sample 10 …”

Section: Discussionmentioning

confidence: 99%

“…Normalisation with serial sampling has been reported in patients with an initially elevated serum prolactin level. [5][6][7][8][9][10][11] However, the rationale for obtaining multiple samples is unclear. We hypothesised that the use of the final, 'most rested' sample would be sufficient to minimise the impact of venepuncture stress.…”

Section: Introductionmentioning

confidence: 99%

“…Our protocol is to obtain three samples from an indwelling cannula over a 40‐min period (0, 20 and 40 min). Normalisation with serial sampling has been reported in patients with an initially elevated serum prolactin level 5–11 . However, the rationale for obtaining multiple samples is unclear.…”

Section: Introductionmentioning

confidence: 99%

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The utility of rested prolactin sampling in the evaluation of hyperprolactinaemia

Wilkinson,

Li,

Soule

et al. 2023

Internal Medicine Journal

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Background and AimsSerum prolactin levels may be elevated by venepuncture stress. We investigated the utility of a rested prolactin sample, obtained through an indwelling venous cannula, in preventing the overdiagnosis of hyperprolactinaemia.MethodsPatients at our institution undergo serial prolactin sampling, usually over 40 min, when investigating hyperprolactinaemia. We retrospectively reviewed all serial prolactin sampling performed during a 3‐year period. Patients with possible medication‐induced hyperprolactinaemia and macroprolactin interference were excluded. We assessed the effect of venepuncture‐associated stress on hyperprolactinaemia with the main outcome being normalisation of serum prolactin at the end of serial sampling.ResultsNinety‐three patients with documented hyperprolactinaemia (range 360–1690 mU/L) were included in the analysis. Prolactin decreased during serial sampling in 73 patients (78%), suggesting a prevalent effect of venepuncture stress. The final prolactin sample was normal in 50 patients (54%), consistent with stress hyperprolactinaemia rather than pathological hyperprolactinaemia. Patients with a referral prolactin result greater than two times the upper reference limit (URL) were less likely (15%) to have a normal prolactin result on serial sampling. Measurement of a single rested prolactin sample from an indwelling cannula showed the same diagnostic utility as serial sampling.ConclusionSerum prolactin results are frequently elevated by the stress of venepuncture. Confirmation of pathological hyperprolactinaemia in a rested sample obtained from an indwelling venous cannula is recommended in patients with mild hyperprolactinaemia, particularly when the referral prolactin is less than two times the URL.

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