Serum Prolactin in Rheumatoid Arthritis: A Possible Marker of Disease Activity
Journal Title: Scholars Academic Journal of Biosciences - Year 2017, Vol 5, Issue 12
Abstract
Rheumatoid arthritis is the most common rheumatic disease which may lead to crippling deformity if not treated properly. Traditional marker of inflammation (ESR, CRP) loss their value in advancing age to ascertain disease activity and many patients continue to have active disease despite aggressive treatment. This study was an endeavor to assess serum prolactin levels in RA patients and its correlation with disease activity.An observational analytic case control study was carried out at a tertiary care center in North-West India among 20 post-menopausal women having rheumatoid arthritis (the case) (diagnosed as per revised American college of Rheumatology 2010 criteria) and 20 age matched healthy post-menopausal women (controls), in accordance with the declaration of Helsinki and after informed consent from participants and permission from institutional ethics committee. The healthy female relatives for the RA patients were taken as control. Females having possible causes of hyperprolactinemia other than RA i.e. deranged renal function test, liver disease, thyroid disorder, seizure and drugs (steroids, antipsychotics, metoclopramide, H2 antagonist, imipramines at least 2 weeks prior to the study) were excluded.After detailed history and thorough rheumatologic assessment; after overnight fasting, venous blood samples of the study participants were drawn from left anticubital vein between 09:30 AM to 12:00 hours noon (at least 2 hours after awakening) and sent for complete blood count, fasting plasma glucose, urea, creatinine, uric acid, SGOT, SGPT, ESR (by Westerngren method), rheumatoid factor (by nephelometry) and CRP (by nephelometry). Serum prolactin was measured by chemiluminescence Immunoassays (CLIA). RA disease activity was measured by DAS28.ESR was significantly higher among RA cases (38.05±24.16 mm/Isthr) compared to control subjects (14.65±8.26 mm/Isthr, p<0.05). Serum prolactin was significantly higher among RA cases (41.08±35.52 ng/ml) compared to non-RA control subjects (10.33±6.19 ng/ml, p<0.05). Among RA cases, serum prolactin was significantly higher in CRP positive cases (n=18) (45.02±35.30 ng/ml) compared to CRP negative RA (n=2) (5.61±1.20 ng/ml) (p<0.05).Serum prolactin was found to have statistically significant correlation with ESR (r= +0.912, p <0.05), tender joint count (r= + 0.833, p <0.05), swollen joint count ( r= + 0.801, p <0.05) and DAS28 ( r= + 0.930, p <0.05). Serum prolactin did not show correlation with disease duration (r= + 0.010, p > 0.05).Prolactin levels are higher in RA patients compared to age/sex matched healthy controls serum prolactin correlated significantly with swollen joint count, tender joint count, ESR and DAS28 (markers of disease activity in RA).
Authors and Affiliations
Dr. Aradhna Singh, Dr. C L Nawal, Dr. Sujata Agrawal, DrKamlesh Sharma, Dr. Laxmi Kant Goyal, Dr. R S Chejara
Keywords
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