Background Prolactin, a hormone with immunomodulatory effects, possible plays a role in the disease activity of Systemic Lupus Erythematosus (SLE). Results of studies are contradictory regarding the correlation between hyperprolactinemia and disease activity.
Objectives To establish whether determination of prolactin is helpful in assessing disease activity in SLE by reviewing relevant literature.
Methods Studies were identified through Medline search. Also references from these articles were reviewed.
Results Ten articles that sought to establish a relationship between prolactin and SLE activity were identified.
Number of patients in the studies varied from 29 to 192, aged 16–73 years, and the percentage of elevated serum prolactin levels in SLE patients was between 2.2–40%. The SLEDAI was used as disease activity index in 7/10 studies. The presence of conditions known to be associated with hyperprolactinemia were either reported or excluded. Steroids treatment was accepted in all studies, DMARDs were used in 8/10 studies. In 5/10 studies bloodsamples were collected midmorning and in 4/10 patients had to fast. Single measurement of serum prolactin concentration and disease activity was done in 6 studies. The other 4 studies had 2–4 measurements per patient. Pearson?s correlation coefficient was the used statistical analysis in 7/10 studies. A relation between prolactin and disease activity was reported in one study. The number of included patients in the studies was small and different statistical methods were used.
Conclusion The correlation between serum prolactin levels and disease activity is still uncertain. A cross-sectional as well as longitudinal study with using the correct statistics, power calculation and proper recording of secondary causes of elevated prolactin and medication need to be done.
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