title: 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).
  
  
  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: Division of Neuro-endocrinology, Beaumont Hospital and the RCSI Medical School, Beaumont Road, Dublin 9, Ireland.
authors: L A
authors: LA
authors: Behan
authors: E P
authors: EP
authors: O'Sullivan
authors: N
authors: N
authors: Glynn
authors: C
authors: C
authors: Woods
authors: R K
authors: RK
authors: Crowley
authors: T K
authors: TK
authors: Tun
authors: D
authors: D
authors: Smith
authors: C J
authors: CJ
authors: Thompson
authors: A
authors: A
authors: Agha
mesh_terms: D000236:Adenoma / Q000097:blood*; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D018491:Dopamine Agonists / Q000627:therapeutic use; D005260:Female; D006801:Humans; D006966:Hyperprolactinemia / Q000097:blood* / Q000188:drug therapy; D008297:Male; D008875:Middle Aged; D010911:Pituitary Neoplasms / Q000097:blood*; D011388:Prolactin / Q000097:blood*; D015175:Prolactinoma / Q000097:blood / Q000188:drug therapy; D012189:Retrospective Studies
chemical_list: D018491:Dopamine Agonists; C060678:prolactin, polymeric; D011388:Prolactin
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