{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,13]],"date-time":"2026-07-13T23:29:43Z","timestamp":1783985383741,"version":"3.55.0"},"reference-count":15,"publisher":"The Endocrine Society","issue":"8","license":[{"start":{"date-parts":[[2025,6,24]],"date-time":"2025-06-24T00:00:00Z","timestamp":1750723200000},"content-version":"vor","delay-in-days":11,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,6,13]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>A 21-year-old man admitted to the hospital for acute kidney injury developed blindness 5 days after admission. Workup included magnetic resonance imaging, which was terminated prematurely due to a ball bearing\/air gun pellet in his neck causing pain. His incomplete scan revealed a large sellar mass causing significant compression of the optic chiasm. Hormone testing showed low levels of IGF-1 and testosterone. A mildly elevated prolactin (PRL) level was attributed to stalk effect and decreased kidney function. For treatment, the patient underwent transsphenoidal tumor resection. Unexpectedly, pituitary immunohistochemistry revealed a prolactinoma. Further inquiry corroborated a history of headache, hypogonadal symptoms, and gynecomastia. He was started on a dopamine agonist with improvement in his vision and hormone levels; however, PRL was further increased. In retrospect, the mildly elevated PRL on initial testing was caused by the high-dose hook effect whereby excessively high PRL levels result in erroneously low measurements by immunoassays. Thus, in patients presenting with large sellar masses and normal\/mildly elevated PRL, the sample should be diluted to exclude high-dose hook effect and ensure an accurate level. In addition, questioning of metallic fragments in plain language may help prevent magnetic resonance imaging injury.<\/jats:p>","DOI":"10.1210\/jcemcr\/luaf136","type":"journal-article","created":{"date-parts":[[2025,6,29]],"date-time":"2025-06-29T03:17:24Z","timestamp":1751167044000},"source":"Crossref","is-referenced-by-count":1,"title":["High-dose Hook Effect in a Case of Giant Prolactinoma Confounded by Acute Kidney Injury"],"prefix":"10.1210","volume":"3","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3667-5205","authenticated-orcid":false,"given":"Anna","family":"Lam","sequence":"first","affiliation":[{"name":"Division of Endocrinology & Metabolism, Department of Medicine, University of Alberta , Edmonton, AB T6G 2S2 ,","place":["Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Connie","family":"Prosser","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine and Pathology, University of Alberta , Edmonton, AB T6G 1C9 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