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Endocrinol Diabetes Metab. 2019 Mar 23;2(3):e00065. doi: 10.1002/edm2.65. eCollection 2019 Jul.

Serum prolactin overestimation and risk of misdiagnosis.

De Sousa SMC1,2,3,4, Saleem M3,5, Rankin W1,3,5, Torpy DJ1,3.

Author information

1
Endocrine and Metabolic Unit Royal Adelaide Hospital Adelaide South Australia Australia.
2
Department of Genetics and Molecular Pathology, Centre for Cancer Biology an SA Pathology and University of South Australia Alliance Adelaide South Australia Australia.
3
School of Medicine University of Adelaide Adelaide South Australia Australia.
4
Adult Genetics Unit Royal Adelaide Hospital Adelaide South Australia Australia.
5
Department of Chemical Pathology SA Pathology Adelaide South Australia Australia.

Abstract

Background:

Falsely elevated prolactin measurements risk overdiagnosis, and unnecessary imaging and treatment.

Design:

We conducted a clinical audit of 18 patients who presented with hyperprolactinaemia, followed by a laboratory audit of 40 split samples across a range of serum prolactin (5-5051 mIU/L). In each case (total n = 58), serum prolactin was measured on both Roche and Siemens platforms.

Results:

Serum prolactin as measured by Roche was higher than the corresponding Siemens value in every case, despite similar reference ranges. The mean discrepancy in serum prolactin by Roche vs. Siemens was +81% in the clinical audit and +50% in the laboratory audit. This led to unnecessary interventions in 7/18 patients (39%) in the clinical audit.

Conclusions:

Serum prolactin is overestimated on the Roche relative to the Siemens platform. Laboratories should review Roche reference intervals for serum prolactin, and clinicians should consider repeating serum prolactin on another platform if the serum prolactin is incongruent with the clinical scenario.

KEYWORDS:

hyperprolactinaemia; pituitary; prolactin

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