Will you share your approach to the follow-up lab proceedures which you use when patients have prolactin results outside the reference range.
We have a two stage protocol. PEG pptation and full gel-filtration. We offer this service to other labs. At what level of prolactin is it worthwhile to perform these additional tests?
Our current SOP states, "ALL samples with Prolactin concentrations above the reference range and with no obvious cause or history, should be referred for macroprolactin screening test eg
Males with serum prolactin > 324 mU/L, Non-pregnant females with serum prolactin > 496 mU/L. A recover of >60% is considered negative for macroprolactin. Monomeric Prolactin 41-59% refer sample for further analysis by Gel filtration."
The gel filtration is time consuming and expensive. I feel that it should only be used where there is a substantial increase in total measured prolactin. At what level is it approriate to employ gel filtration?
We use the Roche cobas Prolactin ll reagent kit, Cat. No. 03203093 190
Regards,
David.
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