Serum prolactin concentration at presentation of non-functioning pituitary macroadenomas.

Abstract

OBJECTIVE:

Serum PRL levels at presentation may be useful in distinguishing between disconnection hyperprolactinemia in non-secretory pituitary adenomas and prolactinomas in order to guide appropriate therapy; however, there is a debate regarding the discriminatory PRL thresholds. We aimed to examine PRL concentrations at presentation in a cohort of histologically proven non-functioning pituitary adenomas (NFPA).

DESIGN AND METHODS:

Retrospective case note analysis was performed. Clinical, biochemical, histopathological and radiological data were recorded and analyzed. Complete data were available for 250 subjects with NFPA.

RESULTS:

Of the study population, 44.8% were hyperprolactinemic at presentation, 55.3% of whom were female. Of those with hyperprolactinemia, 73.2% had PRL<1000 mIU/l on presentation, 24.1% had PRL between 1000 and 1999 mIU/l. Only 2.7% (no.=3 females, 1.2% whole cohort) had PRL>2000 mIU/l (94.3 ng/ml), 2 of whom were pregnant. No male subject and no subjects with an intrasellar macroadenoma had serum PRL>1000 mIU/l (47.2 ng/ml). Overall, serum PRL was not higher among 43 subjects taking medications known to raise PRL.

CONCLUSIONS:

Our data support recent evidence that the serum PRL concentration is rarely >1000 mIU/l in males, or >2000 mIU/l in females, with non-functioning macroadenomas and that, once other contributing factors to the hyperprolactinemia have been excluded, a trial of dopamine agonist therapy for such lesions is indicated.

• Authors: L A Behan, E P O'Sullivan, N Glynn, C Woods, R K Crowley, T K Tun, D Smith, C J Thompson, A Agha
• Journal: Journal of endocrinological investigation (J Endocrinol Invest) 2013 Jul-Aug Vol. 36 Issue 7 Pg. 508-14 ISSN: 1720-8386 [Electronic] Italy
• PMID: 23385474 (Publication Type: Journal Article)

Chemical References

• Dopamine Agonists
• prolactin, polymeric
• Prolactin

Topics

• Adenoma (blood)
• Adolescent
• Adult
• Aged
• Aged, 80 and over
• Cohort Studies
• Dopamine Agonists (therapeutic use)
• Female
• Humans
• Hyperprolactinemia (blood, drug therapy)
• Male
• Middle Aged
• Pituitary Neoplasms (blood)
• Prolactin (blood)
• Prolactinoma (blood, drug therapy)
• Retrospective Studies