Yener Serkan, Comlekci Abdurrahman, Arda Nuri, Men Suleyman, Yesil Sena
Department of Internal Medicine, Division of Endocrinology and Metabolism, School of Medicine, Dokuz Eylul University, Izmir, Turkey.
Med Princ Pract. 2008;17(5):429-31. doi: 10.1159/000141512. Epub 2008 Aug 6.
To describe a patient who was misdiagnosed as having a nonfunctional pituitary tumor due to the hook effect on prolactin measurements.
A 45-year-old female was admitted with visual disturbances, panhypopituitarism and central diabetes insipidus due to pituitary tumor recurrence. She had been operated 4 times earlier and received cranial irradiation for a suspected nonfunctional pituitary adenoma. Serum prolactin was moderately elevated (164.5 ng/ml), but increased markedly after 1:100 dilution to 14,640 ng/ml. Diagnosis of a giant macroprolactinoma was made and cabergoline was started. Prolactin level normalized and a mild shrinkage of the tumor was achieved after 12 months of therapy.
The hook effect must be kept in mind while evaluating a giant pituitary adenoma with moderately elevated prolactin levels. This way unnecessary surgical procedures or irradiation may be avoided.
描述一名因泌乳素检测中的钩状效应而被误诊为无功能垂体瘤的患者。
一名45岁女性因垂体瘤复发出现视力障碍、全垂体功能减退和中枢性尿崩症入院。她此前接受过4次手术，并因疑似无功能垂体腺瘤接受过颅脑放疗。血清泌乳素中度升高（164.5 ng/ml），但在1:100稀释后显著升高至14,640 ng/ml。诊断为巨大泌乳素瘤并开始使用卡麦角林治疗。治疗12个月后，泌乳素水平恢复正常，肿瘤略有缩小。
在评估泌乳素水平中度升高的巨大垂体腺瘤时，必须牢记钩状效应。这样可以避免不必要的手术或放疗。
