A Case of Giant Prolactinoma with a Discrepancy between the Effects of Cabergoline on Serum Prolactin Level and Tumor Size

Abstract PURPOSE Preoperative diagnosis of prolactinomas is critical because medication of dopamine agonists instead of surgical resection has been regarded as a primary treatment. However, serum prolactin level alone is suboptimal for differentiating the prolactin producing adenoma or hyperprolactinemia-causing NFPAs. The author investigated the use of ratio of PRL levels to the tumor size as the optimal cutoff value for prolactin-producing tumor, comparing with the NFPA. METHOD We performed a retrospective review of patients who underwent the transsphenoidal surgery (TSS) for pituitary lesions in the single institute between January 2015 to May 2020. A total of 223 patients with hyperprolactinemia at the initial diagnosis were analyzed in the study, including NFPA patients (n=175) and prolactinoma patients (n=48). Receiver operating curve (ROC) analyses were performed for serum prolactin levels (PRL) and serum prolactin levels/tumor maximal diameter (PRL/MD). RESULT Prolactinoma group showed higher median values in serum PRL (258.6 μg/L) and smaller maximal tumor diameter (16.6 mm), compared to those of NFPA group (serum PRL 44.4 μg/L, p-value = 0.002 and MD 23.9 mm, p-value < 0.001). A moderate correlation was found between serum prolactin level and maximal diameters in prolactinomas (r=0.43, p=0.002), whereas a weak relationship was confirmed in NFPAs (r=0.17, p=0.028). The cutoff was 8.93 μg/L*mm (area under the curve [AUC] = 0.94) for PRL/MD and 99.43 μg/L for PRL (AUC = 0.91). In prolactinomas, there was no statistical difference between the PRL/MD of macroadenomas (n=36, 21.7μg/L*mm) and microadenoma (n=12, 16.8μg/L*mm) (p=0.109). CONCLUSION The serum PRL levels and tumor size exhibited stronger linear correlation in prolactinomas than in NFPAs. The PRL/MD ratio showed better diagnostic value for differentiating two pathologies than the serum PRL levels alone. These findings suggest PRL/MD ratio may be an alternative method to preoperative diagnosis of prolactinomas differentiating from hyperprolactinemia-causing NFPAs.

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Serum prolactin level to tumor size ratio as a potential parameter for preoperative differentiation of prolactinomas from hyperprolactinemia-causing non-functional pituitary adenomas.

World Neurosurgery ◽

10.1016/j.wneu.2021.12.074 ◽

2021 ◽

Author(s):

Jeong-Hwa Kim ◽

Kyu-Yeon Hur ◽

Sang-Duk Hong ◽

Jung-Won Choi ◽

Ho-Jun Seol ◽

...

Keyword(s):

Tumor Size ◽

Prolactin Level ◽

Pituitary Adenomas ◽

Size Ratio ◽

Potential Parameter ◽

Serum Prolactin ◽

Serum Prolactin Level

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SERUM PROLACTINE LEVEL IN PATIENTS OF PSORIASIS VULGARIS AND ITS CORRELATION WITH DISEASE SEVERITY: A CASE-CONTROL STUDY

International Journal of Medical and Biomedical Studies ◽

10.32553/ijmbs.v3i6.303 ◽

2019 ◽

Vol 3 (6) ◽

Author(s):

Pawan Kumar Saini ◽

Devendra Yadav ◽

Rozy Badyal ◽

Suresh Jain ◽

Arti Singh ◽

...

Keyword(s):

Disease Severity ◽

Prolactin Level ◽

Case Control Study ◽

Statistical Significance ◽

Case Control ◽

Serum Prolactin ◽

P Value ◽

Serum Prolactin Level ◽

R Value ◽

Control Study

Background: Psoriasis is an autoimmune chronic inflammatory disorder affecting the skin mediated by T-lymphocytes resulting in production of cytokines which cause hyperproliferation of keratinocytes. Several factors and hormones like Prolactin have an action similar to these cytokines in promoting the multiplication of keratinocytes and other cells like lymphocytes and epithelial cells may have a role on the etiopathogenesis of psoriasis. Aim:-The aim of study is to compare the serum Prolactin levels in patients of psoriasis with a control group. Setting and study design: This is a case-control study conducted in the department of Dermatology, Venereology and Leprosy GMC, Kota over a period of 1year from July 2017 to June 2018 Material and method: The study included 100 cases of psoriasis (60 males and 40 females) and 100 controls similar for age and sex. Serum Prolactin levels were measured by ECLIA and results were obtained. Statistical analysis: Mean and standard deviation were calculated for each variable. Statistical significance of the results was analyzed using correlation analysis (Pearson correlation coefficient) and independent samples t-test. Statistical significance was assumed at p value<0.05. Result: Serum Prolactin level was significantly higher in cases of psoriasis compared to controls (p-value <0.001). PASI score and serum Prolactin levels were found to have a positive correlation (r value = 0.337; p-value: 0.001). No significant correlation was found between serum levels of Prolactin and duration of disease r value= -0.034, P value =0.733). Serum Prolactin level was higher in male patients compared to females patients. Conclusion:- High serum Prolactin may be a biological marker of disease severity in psoriasis and may have a role in the pathogenesis of psoriasis. Further studies with large sample size are required to confirm this hypothesis.

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MONITORING OF THE SERUM PROLACTIN LEVEL IN PATIENTS WITH SCHIZOPHRENIA PASSED TO 3 MONTHLY FROM 1 MONTHLY PALIPERIDONE THERAPY

10.26226/morressier.5d1a037957558b317a1408c3 ◽

2019 ◽

Author(s):

Ersin Hatice Karslioglu ◽

ZEYNEP CAKIR ◽

ALİ CAYKOYLU

Keyword(s):

Prolactin Level ◽

Serum Prolactin ◽

Serum Prolactin Level

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Fawzy M. Khalila ,Serum prolactin level as a biological marker of severity in liver cirrhosis.

Benha Medical Journal ◽

10.21608/bmfj.2017.69221 ◽

2017 ◽

Vol 34 (2) ◽

pp. 140-145

Author(s):

Fawzy M. Khalil ◽

Mohamed A. Elassal ◽

Ahmed M. Hussein ◽

Mahmoud Rizk ◽

Mohamed A. Awadein ◽

...

Keyword(s):

Liver Cirrhosis ◽

Prolactin Level ◽

Biological Marker ◽

Serum Prolactin ◽

Serum Prolactin Level

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The association between serum prolactin levels and interleukin-6 and systemic lupus erythematosus activity

Reumatismo ◽

10.4081/reumatismo.2018.1075 ◽

2018 ◽

Vol 70 (4) ◽

pp. 241-250 ◽

Cited By ~ 4

Author(s):

W.A. Wan Asyraf ◽

M.S. Mohd Shahrir ◽

W. Asrul ◽

A.W. Norasyikin ◽

O. Hanita ◽

...

Keyword(s):

Systemic Lupus Erythematosus ◽

Lupus Nephritis ◽

Disease Activity ◽

Lupus Erythematosus ◽

Prolactin Level ◽

Serum Prolactin ◽

Systemic Lupus ◽

Serum Prolactin Level ◽

Active Lupus Nephritis ◽

Active Lupus

Based on the recent evidence of association between hyperprolactinemia and systemic lupus erythematosus disease activity (SLEDAI), a study was conducted to analyze the association of hyperprolactinemia with lupus nephritis disease activity. In this cross-sectional study, the analysis was conducted on SLE patients who visited the University Kebangsaan Malaysia Medical Centre (UKMMC) Nephrology Clinic from August 2015 till February 2016. The disease activity was measured using the SLEDAI score, with more than 4 indicating active lupus nephritis. Basal resting prolactin level was analyzed in 43 patients with lupus nephritis, in 27.9% of them had raised serum prolactin. The median of serum prolactin level at 0 minutes was 19.91 ng/mL (IQR: 15.95-22.65 ng/ mL) for active lupus nephritis, which was significantly higher compared to the median of serum prolactin level of 14.34 ng/mL (IQR: 11.09-18.70 ng/mL) for patients in remission (p=0.014). The serum prolactin level positively correlated with SLEDAI (rhos: 0.449, p=0.003) and the UPCI level in lupus nephritis patients (rhos: 0.241, p=0.032). The results were reproduced when the serum prolactin was repeated after 30 minutes. However, the serum prolactin levels at 0 minutes were higher than those taken after 30 minutes (p=0.001). An assessment of serum IL-6 levels found that the active lupus nephritis patients had a higher median level of 65.91 pg/ mL (IQR: 21.96-146.14 pg/mL) compared to the in-remission level of 15.84 pg/mL (IQR: 8.38-92.84 pg/mL), (p=0.039). Further correlation analysis revealed that there was no statistical correlation between the interleukin (IL)-6 levels with serum prolactin, SLEDAI and other lupus nephritis parameters. An ROC curve analysis of serum prolactin at 0 minutes and serum prolactin after 30 minutes and IL-6 levels for prediction of SLE disease activity provided the cutoff value of serum prolactin at 0 minutes, which was 14.63 ng/mL with a sensitivity of 91.7% and specificity of 58.1% and AUC of 0.74 (p=0.015). This study concurred with the previous findings that stated that hyperprolactinemia is prevalent in SLE patients and correlated with clinical disease activity and UPCI level. The baseline of the fasting serum prolactin level was found to be a sensitive biomarker for the evaluation of lupus nephritis disease activity.

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Forbes albright syndrome: galactorrhea–amenorrhea associated with a pituitary tumour: a case report

Journal of Diabetes Metabolic Disorders & Control ◽

10.15406/jdmdc.2021.8.00217 ◽

2021 ◽

Vol 8 (1) ◽

pp. 27-29

Author(s):

Rupak Chatterjee ◽

Prantiki Halder ◽

Sudeshna Mallik ◽

Bibhuti Saha

Keyword(s):

Case Report ◽

Prolactin Level ◽

Pituitary Tumour ◽

Serum Prolactin ◽

Loss Of Consciousness ◽

Pituitary Macroadenoma ◽

Serum Prolactin Level ◽

Mri Brain ◽

Menstrual Irregularities ◽

Albright Syndrome

Forbes Albright syndrome is a hyperprolactinemia syndrome characterised by galactorrhea and amenorrhea associated with a pituitary tumour. Here we report a case of 30 years female who was admitted with menstrual irregularities for 4 months, galatorrhea and headache with recurrent episodes of loss of consciousness for 3months. Her serum prolactin level was highly raised. MRI brain (plain plus contrast) showed enlarged pituitary gland- pituitary macroadenoma. She was diagnosed as a case of Forbes Albright Syndrome and was treated with Tablet Cabergoline. With the medication, size of her tumour markedly reduced and symptoms resolved as she was followed up after 3 months.

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