Journal of Human Reproductive Sciences

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

Correspondence Address:
Viroj Wiwanitkit
Wiwanitkit House, Bangkhae, Bangkok - 10160
Thailand




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;3:160-160


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 2021 Jan 17 ];3:160-160
Available from: https://www.jhrsonline.org/text.asp?2010/3/3/160/74163


Full Text

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

1Agarwal M, Das A, Singh SA. Hyperprolactinemia with normal serum prolactin: Its clinical significance. J Hum Reprod Sci 2010;3:111-2.
2Nahid E. Fertility Rate with bromocriptine in infertile women with galactorrhoea and normal prolactin level. Int Congr Ser 2004;1271:22-5.
3Schφfl 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.
4Al Sifri SN, Raef H. The hook effect in prolactin immunoassays. Saudi Med J 2004;25:656-9.
5Frieze TW, Mong DP, Koops MK. "Hook effect" in prolactinomas: Case report and review of literature. Endocr Pract 2002;8:296-303.
6St-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.