The utility of rested prolactin sampling in the evaluation of hyperprolactinaemia
Background and Aims Serum 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. Methods Patients at our institution undergo serial prola...
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Published in | Internal medicine journal Vol. 54; no. 2; pp. 307 - 311 |
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Main Authors | , , , |
Format | Journal Article |
Language | English |
Published |
Melbourne
John Wiley & Sons Australia, Ltd
01.02.2024
Wiley Subscription Services, Inc |
Subjects | |
Online Access | Get full text |
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Summary: | Background and Aims
Serum 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.
Methods
Patients 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.
Results
Ninety‐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.
Conclusion
Serum 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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Bibliography: | Conflict of interest: None. Funding: None. ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 |
ISSN: | 1444-0903 1445-5994 |
DOI: | 10.1111/imj.16208 |