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Prolactin, Ferritin, Vitamin D, and TPA Levels in Autoimmune Diseases
a Department of Medicine B, Wolfson Medical Center, Holon, Israel b Department of Medicine C, Wolfson Medical Center, Holon, Israel c Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel d Department of Medicine D, Meir Medical Center, Kfar Saba, Israel e Immunology Lab for Tumor Diagnosis, Hadassah-Hebrew University Medical Center, Jerusalem, Israel f Third Department of Medicine, University of Debrecen Medical and Health Science Center, Debrecen, Hungary g First Department of Medicine, University of Debrecen Medical and Health Science Center, Debrecen, Hungary h Neurology Department, University of Debrecen Medical and Health Science Center, Debrecen, Hungary i Rheumatology Division, Sao Paulo University Medical School Hospital, Sao Paulo, SP, Brazil j Division of Rheumatology and Department of Clinical and Experimental Medicine, University of Padova, Padova, Italy k Department of Medicine B and Center of Autoimmune Diseases, Sheba Medical Center, Tel-Hashomer, Israel
Key Words: prolactin • ferritin • vitamin D • tissue polypeptide antigen • TPA • SLE • rheumatoid arthritis • multiple sclerosis • polymyositis • dermatomyositis
Address for correspondence: Hedi Orbach, M.D., Head, Department of Medicine B, Wolfson Medical Center, Holon, 58100, Israel. Voice: 972-3-5028742; fax: 972-3-5028116. orbach{at}wolfson.health.gov.il
The development of autoimmune diseases may be influenced by hormonal, immunomodulatory, and metabolic pathways. Prolactin (PRL), ferritin, vitamin D, and the tumor marker tissue polypeptide antigen (TPA) were measured in autoimmune diseases: systemic lupus erythematosus (SLE), systemic sclerosis (SSc), rheumatoid arthritis (RA), polymyositis (PM), dermatomyositis (DM), multiple sclerosis (MS), autoimmune thyroid diseases, and antiphospholipid syndrome. Hyperprolactinemia (HPRL) was detected in 24% of PM patients, in 21% of SLE patients, in 6.7% of MS patients, 6% of RA patients, and in 3% of SSc patients. Hyperferritinemia was detected in 23% of SLE patients, 15% of DM patients, 8% of MS patients, and 4% of RA patients. The patients had relatively low levels of 25 OH Vitamin D: the average results (mean ± SD) were between 9.3 ± 4.4 to 13.7 ± 7.1 ng/mL in the different diseases, while the 25 OH Vitamin D concentrations less than 20 ng/mL are regarded as deficient. TPA levels were in the same range of the controls, elevated only in SLE. HPRL, hyperferritinemia, hypovitaminosis D, and TPA levels did not correlate with SLE activity elevated levels of rheumatoid factor or anti-CCP antibodies in RA. HPRL, hyperferritinemia, and hypovitaminosis D have different immunological implications in the pathogenesis of the autoimmune diseases. Preventive treatment with vitamin D or therapy for HPRL with dopamine agonists, may be considered in certain cases. Hyperferritinemia may be used as an acute-phase reactant marker in autoimmune diseases mainly SLE. TPA may be used to indicate the tendency for malignancies.
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