Oral Presentation ESA-SRB 2023 in conjunction with ENSA

The Rise & Fall of Serum Prolactin – To Rest or Not To Rest?   (#48)

Roghaya Fatouros 1 , Julie Hetherington 1 2 , Ashish Gargya 1 3 , Albert Hsieh 1 4
  1. Department of Endocrinology, Royal Prince Alfred Hospital, Camperdown, NSW, Australia
  2. Susan Wakil School of Nursing and Midwifery, University of Sydney, Sydney, NSW, Australia
  3. Faculty of Medicine & Health, University of New South Wales, Sydney, NSW, Australia
  4. Central Clinical School, Faculty of Medicine, University of Sydney, Sydney, NSW, Australia

Pathological hyperprolactinaemia may be associated with hypogonadotropic hypogonadism. There are many physiological causes of hyperprolactinaemia such as pregnancy and stress. A single elevated non-rested prolactin level may lead to overdiagnosis and unnecessary pituitary imaging [1]. We conducted a study to demonstrate that a time-based rested prolactin testing reduces the overdiagnosis of hyperprolactinaemia.

Study patients were recruited from January 2019 to July 2023 through Royal Prince Alfred Hospital (RPAH) Endocrinology if there was a single elevated serum prolactin level. Patients were referred from RPAH Fertility Unit and Endocrinologists. Exclusion criteria included symptomatic or medication-induced hyperprolactinaemia, history of pituitary disorder and macroprolactinaemia.

Thirty-two patients were included (29 females, 3 males). Mean age was 33.7 (±8.5 SD) years. Fifty-three percent of the cohort were Caucasian. The pre-testing prolactin mean was 975mIU/L (±531 SD). Nine out of 32 patients had a normal rested prolactin (≤500mIU/L) at baseline. At completion, 18 patients had a prolactin level >500mIU/L. Sub-analysis indicated four more patients would have likely achieved a prolactin level ≤500mIU/L if rested longer.

 

 

[1] Whyte MB, et al. Importance of cannulated prolactin test in the definition of hyperprolactinaemia. Pituitary 2015:18(3);319-25.