Increased demand for steroid therapy in hyperprolactinemic patients with rheumatoid arthritis

The role of increased plasma prolactin (PRL.) in rheumatoid arthritis (RA) is not fully explained. The aim of this study was to compare the clinical f eatures and the treatment administered in RA patients with normal and eleva ted plasma PRL concentrations. Forty-nine patients with rheumatoid arthriti s and 16 healthy subjects were included in this study. In healthy controls, PRL concentrations were 7.6 mu /l (median), in 34 patients plasma PRL was less than 20 mu /l (9.9 mu /l) and in 15 patients it was elevated, with a m edian of 26.7 mu /l. No differences in clinical features were found compare d with normal or increased plasma PRL. The introduction of corticoid therap y produced a significant difference. Steroid therapy was administered to 93 % of the patients with hyperprolactinemia, compared with 59% of those with normal PRL concentrations. Daily prednisone doses higher than 5 mg were adm inistered to 43% of the patients with elevated PRL, compared with 25% of pa tients with normal prolactin concentrations. In conclusion, the clinical fe ature of patients with rheumatoid arthritis did not differ in subjects with elevated PRL concentrations and in those with normal concentrations. The d ifference between these two groups was in the higher demand for steroid the rapy in patients with hyperprolactinemia.