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LETTER TO EDITOR  
Year : 2010  |  Volume : 3  |  Issue : 3  |  Page : 160
 

Hyperprolactinemia with normal serum prolactin: "Hook effect" a concern in laboratory medicine aspect

Viroj Wiwanitkit
Wiwanitkit House, Bangkhae, Bangkok - 10160, Thailand

Date of Web Publication23-Dec-2010

Correspondence Address:
Viroj Wiwanitkit
Wiwanitkit House, Bangkhae, Bangkok - 10160
Thailand
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0974-1208.74163

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How to cite this article:
Wiwanitkit V. Hyperprolactinemia with normal serum prolactin: "Hook effect" a concern in laboratory medicine aspect. J Hum Reprod Sci 2010;3:160

How to cite this URL:
Wiwanitkit V. Hyperprolactinemia with normal serum prolactin: "Hook effect" a concern in laboratory medicine aspect. J Hum Reprod Sci [serial online] 2010 [cited 2020 Dec 2];3:160. Available from: https://www.jhrsonline.org/text.asp?2010/3/3/160/74163


Sir,

I read the interesting case report by Agarwal et al., with a great interest. [1] There are some additional discussions on this case. It is no doubt that "all gynecologists should consider galactorrhea even in women with normal serum prolactin." [2] The interpretation of the serum prolactin level needs careful consideration. In laboratory medicine, the false negative in prolactin level determination can be expected. A high-dose hook effect in the PRL assay that leads to falsely low serum prolactin level is mentioned in some literatures. [3],[4],[5],[6] The hook effect should be considered in any case with a large pituitary mass. [4] A pre-dilution preparation can help in solving this specific false negative problem. [3],[4],[5],[6]

 
   References Top

1.Agarwal M, Das A, Singh SA. Hyperprolactinemia with normal serum prolactin: Its clinical significance. J Hum Reprod Sci 2010;3:111-2.  Back to cited text no. 1
    
2.Nahid E. Fertility Rate with bromocriptine in infertile women with galactorrhoea and normal prolactin level. Int Congr Ser 2004;1271:22-5.  Back to cited text no. 2
    
3.Schφfl C, Schφfl-Siegert B, Karstens JH, Bremer M, Lenarz T, Cuarezma JS, et al. Falsely low serum prolactin in two cases of invasive macroprolactinoma. Pituitary 2002;5:261-5.  Back to cited text no. 3
    
4.Al Sifri SN, Raef H. The hook effect in prolactin immunoassays. Saudi Med J 2004;25:656-9.  Back to cited text no. 4
    
5.Frieze TW, Mong DP, Koops MK. "Hook effect" in prolactinomas: Case report and review of literature. Endocr Pract 2002;8:296-303.  Back to cited text no. 5
    
6.St-Jean E, Blain F, Comtois R. High prolactin levels may be missed by immunoradiometric assay in patients with macroprolactinomas. Clin Endocrinol (Oxf) 1996;44:305-9.  Back to cited text no. 6
    




 
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