The value of prolactin in predicting prolactinοma in hyperprolactinaemic polycystic ovarian syndrome

Kyritsi, Eleni Magdalini, Dimitriadis, Georgios K., Angelousi, Anna, Mehta, Hiten, Shad, Amjad, Mytilinaiou, Maria, Kaltsas, Gregory and Randeva, Harpal S. (2018). The value of prolactin in predicting prolactinοma in hyperprolactinaemic polycystic ovarian syndrome. European journal of clinical investigation, 48 (7),

Abstract

Background: To identify a serum prolactin (PRL) cut-off value indicative of a PRL-producing adenoma in women with polycystic ovarian syndrome (PCOS) and hyperprolactinaemia and characterize such patients. Materials and methods: In the present retrospective case–control study, the medical records of 528 PCOS women were reviewed. Pituitary magnetic resonance imaging (MRI) was performed in PCOS patients with PRL levels ≥94.0 ng/mL and/or symptoms suspicious of a pituitary adenoma (PA). Prolactinoma diagnosis was made in the presence of an MRI-identifiable PA with biochemical and radiological response to dopamine agonists. Receiver operating characteristic (ROC) curve analysis was performed to determine a serum PRL threshold that could identify hyperprolactinaemic PCOS subjects with prolactinomas. Clinical, metabolic and endocrine parameters were also analysed. Results: Among 528 patients with PCOS, 60 (11.4%) had elevated PRL levels. Of 44 (73.3%) patients who had pituitary imaging, 19 had PAs, 18 normal MRI and 7 other abnormalities. Patients harbouring prolactinomas had significantly higher PRL levels compared to patients without adenomas (median PRL 95.4 vs 49.2 ng/mL, P <.0001). A PRL threshold of 85.2 ng/mL could distinguish patients with prolactinomas with 77% sensitivity and 100% specificity [Area Under the curve (AUC) (95%) 0.91(0.8-1.018), P =.0001]. PCOS women with prolactinomas were younger and had lower LH levels compared to women without prolactinomas. Conclusions: In women with PCOS, PRL levels exceeding 85.2 ng/mL are highly suggestive of a prolactinoma warranting pituitary imaging. Pituitary MRI could also be considered in young PCOS patients with milder PRL elevation and low LH levels.

Publication DOI: https://doi.org/10.1111/eci.12961
Divisions: Aston Medical School
Uncontrolled Keywords: cut-off,hyperprolactinaemia,pituitary MRI,polycystic ovarian syndrome,prolactin,prolactinoma,Biochemistry,Clinical Biochemistry
Full Text Link: http://wrap.war ... k.ac.uk/102847/
Related URLs: http://www.scop ... tnerID=8YFLogxK (Scopus URL)
https://onlinel ... .1111/eci.12961 (Publisher URL)
Published Date: 2018-05-29
Authors: Kyritsi, Eleni Magdalini
Dimitriadis, Georgios K.
Angelousi, Anna
Mehta, Hiten
Shad, Amjad
Mytilinaiou, Maria
Kaltsas, Gregory
Randeva, Harpal S.

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