Immunoradiometric Assays May Miss High Prolactin Levels
Authors: Ronald Comtois
Journal: Annals of Internal Medicine (1993)

Letters15 July 1993Immunoradiometric Assays May Miss High Prolactin LevelsRonald Comtois, MD, Francoise Robert, MD, and Jules Hardy, MDRonald Comtois, MD, Francoise Robert, MD, and Jules Hardy, MDAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-119-2-199307150-00029 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:Measurement of serum prolactin levels is useful in differentiating prolactinoma from other causes of increased prolactin concentrations. Distinguishing between prolactinoma and a nonfunctioning pituitary adenoma, or even nonadenomatous disease, is important because dopamine agonist therapy may reduce tumor size in most macroprolactinomas but is largely ineffective in nonsecreting adenoma and nonadenomatous lesions [1]. Solid-phase sandwich radioimmunoassay (immunoradiometric assay) is frequently used to measure prolactin levels. Results from immunoradiometric assay kits may be subject to the well-documented, high-dose hook effect, or prozone effect, where extremely high serum concentrations of an antigen may paradoxically produce a lower response than ...References1. Barrow DL, Tindall GT, Kovacs K, Thorner MO, Horvath E, Hoffman JC. Clinical and pathological effects of bromocriptine on prolactin-secreting and other pituitary tumours. J Neurosurg. 1984; 60: 1-7. Google Scholar2. Hoffman KL, Parsons GH, Allerdt LJ, Brooks JM, Miles LE. Elimination of hook-effect in two-site immunoradiometric assays by kinetic rate analysis. Clin Chem. 1984; 30:1499-501. Google Scholar3. Saryan JA, Garret PE, Kurtz SR. Failure to detect extremely high levels of serum IgE with an immunoradiometric assay. Ann Allergy. 1989; 63:322-4. Google Scholar4. Glassack RJ. The hook effect: high concentrations of prostate-specific antigen giving low values on one step immunoassay. N Engl J Med. 1989; 320:1755-6. Google Scholar5. Haller BL, Fuller KA, Brown WS, Koenig JW, Evelard BJ, Scott MG. Two automated prolactin immunoassays evaluated with demonstration of a high-dose hook effect in one. Clin Chem. 1992; 38:437-8. Google Scholar Author, Article, and Disclosure InformationAuthors: Ronald Comtois, MD; Francoise Robert, MD; Jules Hardy, MD PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byProlactin immunoassay: does the high-dose hook effect still exist?Efficacy and Cerebrospinal Fluid Rhinorrhea after Cabergoline Treatment in Patients with Bioactive MacroprolactinomaProlactin Producing Adenomas: Prolactinomas and HyperprolactinemiaAn Unusual Case of Galactorrhea With Normal Serum ProlactinUpdate on prolactinomas. Part 1: Clinical manifestations and diagnostic challengesTHERAPY OF ENDOCRINE DISEASE: The challenges in managing giant prolactinomasThe hook effect in calcitonin immunoradiometric assay: A case reportProlactinomasClinical Problem Solving: Monster on the Hook—Case Problems in NeurosurgeryAbsence of hypogonadism in a male patient with a giant prolactinoma: A clinical paradoxGiant invasive pituitary prolactinoma with falsely low serum prolactin: the significance of 'hook effect'Advances in the Treatment of ProlactinomasHigh Dose Hook Effect in MacroprolactinomaHigh-Dose Hook Effect in Patients with MacroprolactinomaQualitative β-hCG urine assays may be misleading in the presence of molar pregnancy: a case reportContemporary management of prolactinomasArmadilhas no diagnóstico da hiperprolactinemia"Hook Effect" in Prolactinomas: Case Report and Review of LiteratureGiant Pituitary Prolactinoma with Falsely Low Serum Prolactin: The Pitfall of the "High-dose Hook Effect": Case ReportPituitary adenomas secreting large amounts of prolactin may give false low values in immunoradiometric assays. The hook effectAcromegaly with Normal Basal Growth Hormone LevelsWhen and How to Stop Cabergoline Treatment in Microprolactinomas 15 July 1993Volume 119, Issue 2Page: 173KeywordsAdenomasAntigensAttentionImmunoradiometric assayPituitary tumorsProlactinReproducibilityReproductive systemSurgeryTumor resection ePublished: 15 August 2000 Issue Published: 15 July 1993 Copyright & PermissionsCopyright © 1993 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...