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Purpose <p>Mild 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.</p> Methods <p>We 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&#xa0;min and 60&#xa0;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.</p> Results <p>We 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&#xa0;min (<i>n</i> = 10) or 60&#xa0;min (<i>n</i> = 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’.</p> Conclusions <p>CPT 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.</p>

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The usefulness of cannulated prolactin test in mild hyperprolactinemia: case series and systematic review of the literature

  • 期刊论文

  • 发表日期：

    2026年1月12日

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  • Tânia Matos,
  • Daniela Dias,
  • Catarina Silvestre,
  • Filipa Serra,
  • Marta Araujo-Castro,
  • Betina Biagetti,
  • Amets Sagarribay,
  • Inês Sapinho,
  • Pedro Marques

摘要

Purpose

Mild 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.

Methods

We 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.

Results

We 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’.

Conclusions

CPT 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.