SynthesisPituitary2026
The usefulness of cannulated prolactin test in mild hyperprolactinemia: case series and systematic review of the literature.
Synthesis in Pituitary, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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1 citing paper in PubMed.
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Authors and funding
9 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeMild hyperprolactinemia can occur due to venipuncture-related stress leading to unnecessary diagnostic investigations/treatment. We aimed to assess the cannulated prolactin testing (CPT) usefulness in the investigation of mild hyperprolactinemia by evaluating our case series and conducting a literature review.
methodsWe conducted a retrospective study including hyperprolactinemia patients on an initial measurement (referral prolactin (rPRL)), who underwent a CPT between 2018–2025. During CPT a catheter was inserted and samples for prolactin were drawn at baseline (PRL0’), 30 min and 60 min. Prolactin normalization was defined as a PRL0’ or nadir PRL within the normal range. For the literature review, we included articles published until 1 October 2025 identified through PubMed and Scopus search.
resultsWe included 105 patients (82% females) with a mean rPRL of 59.5 ± 43.2ng/mL. Sixty-two of 105 patients (59%) had normal prolactin during the CPT, 47 (75.8%) had normal PRL0’ while 15 cases normalized prolactin at 30 min (n = 10) or 60 min (n = 5). PRL0’ predicted normalization with good accuracy (AUC 0.905, 95%CI 0.850–0.960), and optimal cut-off was 30.1ng/mL. Among the 1700 patients from 12 series we analysed, 913 (53.7%) normalized prolactin during the CPT, and 75.3% of these were already normal at timepoint 0’.
conclusionsCPT is useful in excluding hyperprolactinemia in more than 50% of mild hyperprolactinemia patients, avoiding unnecessary imaging, overdiagnosis and treatment. More than three-quarters of patients who normalize prolactin during CPT have normal PRL0’. These data support a stepwise approach in which prolactin is first repeated under stress-free conditions reserving full CPT for those with persistent hyperprolactinemia.
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