Prolactin
Label Mnemonic: PROL
Epic Lab Code: LAB531
Downtime Form: A-1a General Laboratory Requisition
Chemistry
6240 RCP
356-3527
Specimen(s):
Plasma
Collection Medium:
Plasma Separator Tube 4.5 mL
Alternate Collection Media:
Call laboratory for additional acceptable specimen collection containers.
Minimum:
3 mL whole blood light green top tube or TWO Microtainer® devices.
Testing Schedule:
24 hrs/day, 7 days a week, including holidays.
Turn Around Time:
1 hour (upon receipt in laboratory)
Reference Range:
Males: 4.0 - 15.2 ng/mL Females (not pregnant): 4.8 - 23.3 ng/mL Age-based references ranges in children have not been established. References ranges by Tanner stage: Males Stage I: < or = 10.0 ng/mL Stage II-III: < or = 6.1 ng/mL Stage IV-V: 2.8 - 11.0 ng/mL Females: Stage I: 3.6 - 12.0 ng/mL Stage II-III: 2.6 - 18.0 ng/mL Stage IV-V: 3.2 - 20.0 ng/mL Other References Ranges: Cord Blood: 45 - 539 ng/mL Pregnancy, 3rd trimester: 95 - 473 ng/mL
Comments:
As of September 14, 2010, samples that produce results above the upper limit of the gender-specific reference range are no longer screened for the presence of macroprolactin by PEG (polyethylene glycol) precipitation. If screening for macroprolactin is desired, see "Macroprolactin Check".
Test Limitations:
The assay is unaffected by icterus (bilirubin is less than 30 mg/dL), hemolysis = 1500 (Hb is less than 1.5 g/dL), lipemia (Intralipid is less than 1500 mg/dL) and biotin is less than 40 ng/mL (criterion: recovery within plus or minus 10% of initial value). In patients receiving therapy with high biotin doses (i.e. is greater than 5 mg/day) no sample should be taken until at least 8 hours after the last biotin administration. No interference was observed from rheumatoid factor (up to approx. 1100 IU/mL) and samples from dialysis patients. No high dose hook effect at prolactin concentrations of 12690 ng/mL. In vitro tests were performed on 16 commonly used pharmaceuticals. No interference with the assay was found. As with all tests containing monoclonal antibodies, erroneous findings may be obtained from samples taken from patients who have been treated with monoclonal mouse antibodies or who have received them for diagnostic purposes. In rare cases, interference due to extremely high titers of antibodies to ruthenium can occur. Prolactin contains additives which minimize these effects. Extremely high titers of antibodies to streptavidin can occur in isolated cases and cause interference. When determining prolactin it should be remembered that the measured concentration is dependent upon when the blood sample was taken, since the secretion of prolactin occurs in episodes and is also subject to a 24-hour cycle. The release of prolactin is promoted physiologically by suckling and stress. In addition, elevated serum prolactin concentrations are caused by a number of pharmaceuticals (especially dopamine receptor antagonists including antipsychotics), TRH and estrogen. The release of prolactin is inhibited by dopamine, L-dopa and ergotamine derivatives. A number of publications report the presence of macroprolactin in the serum of female patients with various endocrinological diseases or during pregnancy.(1,2) Differing degrees of detection of the serum macroprolactins (ultra-big is greater than 160 kD) relative to monomeric prolactin (22-23kD) by various immuno-assays have also been described. This could make the detection of hyperprolactinemia dependent on the immunoassay used. The prolactin assay also encompasses macroprolactin. Accordingly, higher values may occasionally be found in patient samples than with other assay procedures. For diagnostic purposes, the prolactin findings should always be assessed in conjunction with the patient's medical history, clinical examination and other findings. (1) Dericks-Tan JSE, Siedentopf HG, Taubert HD. Discordant Prolactin Values obtained with Different Immunoassays in an infertile Patient. J Lab Med 1997;21(9):465-470. (2) Leite V, Cosby H, Sobrinho LG, Fresnoza A, Santos MA, Friesen HG. Characterization of big-big prolactin in patients with hyperprolactinoma. Clin Endocrinol 1992;37:365-372.
Methodology:
Electrochemiluminescence Immunoassay
CPT Code:
84146
 
See also:
Macroprolactin Check, Plasma