Abstract:
Prolactin measurement is very common in standard clinical practice. It is indicated not only in the study of pituitary adenomas, but also when there are problems with fertility, decreased libido, or menstrual disorders, among other problems. Inadequate interpretation of prolactin levels without contextualizing the laboratory results with the clinical, pharmacological, and gynecological/urological history of patients leads to erroneous diagnoses and, thus, to poorly based studies and treatments. Macroprolactinemia, defined as hyperprolactinemia due to excess macroprolactin (an isoform of a greater molecular weight than prolactin but with less biological activity), is one of the main causes of such erroneous diagnoses, resulting in poor patient management when not recognized. There is no unanimous agreement as to when macroprolactin screening is required in patients with hyperprolactinemia. At some institutions, macroprolactin testing by polyethylene glycol (PEG) precipitation is routinely performed in all patients with hyperprolactinemia, while others use a clinically based approach. There is also no consensus on how to express the results of prolactin/macroprolactin levels after PEG, which in some cases may lead to an erroneous interpretation of the results. The objectives of this study were: 1. To establish the strategy for macroprolactin screening by serum precipitation with PEG in patients with hyperprolactinemia: universal screening versus a strategy guided by the alert generated by the clinician based on the absence or presence of clinical symptoms or by the laboratory when hyperprolactinemia is detected. 2. To create a consensus document that standardizes the reporting of prolactin results after precipitation with PEG to minimize errors in the interpretation of the results, in line with international standards.
摘要:
催乳素测量在标准临床实践中非常常见。它不仅在垂体腺瘤的研究中表明,但当生育出现问题时,性欲下降,或者月经紊乱,在其他问题中。在没有将实验室结果与临床联系的情况下,对催乳素水平的解释不足,药理学,和患者的妇科/泌尿系统病史导致错误的诊断,因此,基础差的研究和治疗。大泌乳素血症,定义为由于过量的大催乳素(分子量大于催乳素但生物活性较低的同工型)导致的高催乳素血症,是这种错误诊断的主要原因之一,导致患者管理不善时不被识别。对于高催乳素血症患者何时需要进行大催乳素筛查,尚无一致意见。在一些机构,在所有高催乳素血症患者中,通常通过聚乙二醇(PEG)沉淀进行大催乳素测试,而其他人则使用基于临床的方法。对于PEG后如何表达催乳素/大催乳素水平的结果也没有共识,在某些情况下,这可能会导致对结果的错误解释。本研讨的目标是:1。建立高催乳素血症患者通过血清沉淀PEG筛查巨乳催乳素的策略:通用筛查与由临床医生基于临床症状的存在或检测到高催乳素血症时由实验室产生的警报指导的策略。2.为了创建一个共识文件,标准化使用PEG沉淀后催乳素结果的报告,以最大程度地减少结果解释中的错误,符合国际标准。