Correlation of Prolactin Serum Concentrations with Clinical Activity and Remission in Patients with Systemic Lupus Erythematosus. Effect of Conventional Treatment

OLGA VERA-LASTRA, CARMEN MENDEZ, LUIS J. JARA, MARTÍN CISNEROS, GABRIELA MEDINA, RAUL ARIZA, and LUIS R. ESPINOZA

ABSTRACT.

Objective. The role of prolactin (PRL) in the pathogenesis of systemic lupus erythematosus (SLE) is controversial. The effect of conventional treatment (steroids, antimalarials, immunosuppressor drugs) on PRL concentrations is unclear. We investigated correlation of PRL levels with lupus activity in patients at entry and after 6 months of conventional treatment.

Methods. We studied 43 female patients with active SLE, who were divided in 2 groups; Group 1: 16 patients with minor organ involvement (cutaneous and articular involvement), and Group 2: 27 patients with major organ involvement (glomerulonephritis). Controls were 36 healthy individuals. PRL levels were determined by an immunoradiometric assay at entry and after 6 months of treatment. PRL levels were correlated with SLE Disease Activity Index (SLEDAI) score.

Results. Mild hyperprolactinemia (HPRL, 20–40 ng/ml) was found in 30/43 (69.7%) SLE patients. After 6 months of treatment a reduction in PRL levels was found in both groups: Group 1: 24.3 ± 10.8 to 16.96 ± 10.87 ng/ml (p < 0.001); and Group 2: 23.6 ± 5.7 to 12.07 ± 11.13 ng/ml (p < 0.001). The SLEDAI score also decreased after treatment: Group 1: 16.5 ± 5.9 to 2.1 ± 1.3 (p < 0.001); Group 2: 16.8 ± 5.4 to 1.6 ± 1.4 (p < 0.001). At entry and after treatment, a significant correlation between PRL levels and SLEDAI score was found in all patients (r = 0.4946, p = 0.0007, and r = 0.9086, p = 0.0001, respectively).

Conclusion. HPRL was associated with SLE disease activity. Conventional immunosuppressive therapy decreased PRL levels in direct correlation with decreased SLE activity. This finding emphasizes that PRL may play a role in the pathogenesis and clinical expression of SLE. (J Rheumatol 2003;30:2140-6)

Key Indexing Terms:

PROLACTIN
SYSTEMIC LUPUS ERYTHEMATOSUS DISEASE ACTIVITY INDEX
SYSTEMIC LUPUS ERYTHEMATOSUS ACTIVITY

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From the Department of Internal Medicine, Clinical Research Unit, Department of Rheumatology, and Department of Epidemiology, Hospital de Especialidades, Centro Medico "La Raza," Mexico City; Hospital General de Zona no. 76, Instituto Mexicano del Seguro Social, Mexico City, Mexico; and the Rheumatology Section, Louisiana State University (LSU), New Orleans, Louisiana, USA.

O. Vera-Lastra, MD, Associate Professor of Internal Medicine, Universidad Nacional Autonoma de Mexico (UNAM); C. Mendez, MD, Clinical Research Unit; L.J. Jara, MD, Chief, Clinical Research Unit, Associate Professor of Rheumatology, UNAM; M. Cisneros, MD, MSc; G. Medina, MD, MSc; R. Ariza, MD, Chief, Internal Medicine Department, IMSS, Mexico; L.R. Espinoza, MD, Professor of Medicine, Chief, Rheumatology Section, LSU, USA.

Address reprint requests to Dr. L.J. Jara, Clinical Research Unit, Hospital de Especialidades Centro Medico Nacional "La Raza," Seris y Zaachila S/N, Colonia La Raza, CP 02990, Mexico City, Mexico. E-mail: luis_jara_quezada@hotmail.com

Submitted May 6, 2002; revision accepted March 28, 2003.

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