Prolactin in Human Cerebrospinal Fluid*

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Abstract
PRL was measured radioimmunologically in plasma andcerebrospinal fluid (CSF) samples obtained simultaneously in 31 patients with various neurological or infectious, but non-endocrine diseases (group A), 12patients (7 pregnant women and5 newborns) with physiological hyperprolactinemia (group B), 10 psychiatric patients with pharmacologically induced hyperprolactinemia (group C),12 normoprolactinemic patients with pituitary adenoma and suprasellar extension (SSE) (group D),and 14 hyperprolactinemic patients with pituitary adenoma with and withoutSSE (group E). Plasma PRL and CSF PRL concentrations (ng/ml, mean andrange inbrackets) ofthe various groups were: group A,6.2 (1.3–14.5) and1.3 (0.6–4.7); group B, 85.2 (31–200) and13.2(3–28); group C, 54.3 (3.5–160) and 6.5 (0.7–18); group D, 17.2 (5.4–30) and 9.7 (2.7–34);and group E, 2,529 (115–10,000) and 1,449(6–13,000). The plasma toCSFconcentration ratios (mean and rangein brackets) were: group A, 5.2 (1.4–13.0); group B, 7.0 (2.9–10.3); group C, 7.3 (3.9–11.3); group D, 2.6(0.9–7.1); and group E, 10.9 (0.2–34.9). The ratio was? 3 in 87% of the non-tumor patients; in42% of the tumor patients the ratio was< 3.The correlation between plasma and CSF PRL levels of all 53subjects without a pituitary tumor (groups A, B, and C)was positive (r = 0.9097;P = 0.00001); in the26tumor patients (groups D and E) the correlation was also postive (r= 0.7141;P=0.00002). These results indicate that 1) PRL isa normal constituent of CSF, 2) theCSFPRL level isa function of the plasma level, 3)detectable, oreven high, CSF PRL levels per se are notindicative of the presence of a pituitary tumor, with orwithout SSE, and4) abnormally lowratios may be found in patients with a pituitary tumor with SSE.