Hyperprolactinemia Diagnosis Sufficient With Single Test

Guidelines recommend treatment with dopamine agonist therapy, discourage dynamic testing

MONDAY, Feb. 21 (HealthDay News) -- One serum blood test is sufficient to diagnose hyperprolactinemia, and dynamic testing of prolactin secretion should be avoided, according to new guidelines published in the February issue of the Journal of Clinical Endocrinology & Metabolism.

Shlomo Melmed, M.D., from the Cedars Sinai Medical Center in Los Angeles, and Endocrine Society colleagues used the GRADE system -- grading of recommendations, assessment, development, and evaluation -- to analyze recommendations and level of evidence. Clinical practice guidelines for diagnosis and treatment of hyperprolactinemia were reviewed.

The guidelines recommend a single measurement of serum prolactin to diagnose hyperprolactinemia, with a level above the normal limit confirming diagnosis. Dynamic testing of prolactin secretion is not recommended. Following diagnosis, the cause should be established by excluding medication use and pituitary and parasellar tumors. In suspected drug-induced hyperprolactinemia, the drug should be discontinued or replaced. In patients with symptomatic prolactin-secreting microadenomas or macroadenomas, dopamine agonist therapy, preferably cabergoline, can reduce prolactin levels and treat other symptoms. For symptomatic patients whose prolactin levels cannot be reduced, the guidelines suggest increasing the medication before referring a patient for surgery. Pregnant women should discontinue dopamine agonist therapy as soon as possible, and should avoid serum prolactin measurements.

"Testing for hyperprolactinemia is straightforward, owing to the ease of ordering a serum prolactin measurement. Accordingly, an evidence-based, cost-effective approach to management of this relatively common endocrine disorder is required," the authors write.

Several authors disclosed financial relationships with pharmaceutical and medical device companies, including Pfizer and Novartis.

Abstract
Full Text (subscription or payment may be required)

Copyright © 2011 HealthDay. All rights reserved.

Powered by

jQuery UI Accordion - Default functionality

For life-long learning and continuing professional development, come to Lippincott's NursingCenter.

Nursing Jobs Plus
Featured Jobs
Recommended CE Articles Recommended Nursing Articles

What internal motivators drive RNs to pursue a BSN?
Nursing2014 , October 2014
Free access will expire on November 24, 2014.


Breast Cancer Risk Assessment in Primary Care
MCN, The American Journal of Maternal/Child Nursing, September/October 2014
Free access will expire on November 10, 2014.


Nurses spurring innovation
Nursing Management, October 2014
Free access will expire on November 10, 2014.


More Recommended Articles

Subscribe to Recommended Articles

Evidence Based Practice Skin Care Network NursingCenter Quick Links What’s Trending Events