The results of this study showed that the majority of patients with active disease had elevated prolactin levels (70%). Vera  demonstrated the same results, the relationship between disease activity and the presence of hyperprolactinemia, however the population with active disease was less representative in this study.
The prolactin levels found in active disease, a median of 21ng / ml was obtained.
] found prolactin levels > 20ng / ml in those with active clinical disease as well as serological activity.
Of the clinical manifestations included in the MEX-SLEDAI, a higher prevalence of kidney disease (80%) was demonstrated in those with active disease and hyperprolactinemia. A. Capo found that the presence of hyperprolactinemia was statistically significant in active lupus nephritis (p = 0.014). There was also a positive correlation between prolactin level and score of disease activity (SLEDAI) based on Spearman's correlation coefficient. Therefore hyperprolactinemia is involved in lupus nephritis, activity at the level of the central nervous system, and skin and joint manifestations .
Age difference was found in those patients with active disease (p = 0.037), these being younger compared to those with non-active disease, this could be explained by the pathophysiology of the disease since it has a maximum incidence during the reproductive years due to the highest proportion of women with SLE of reproductive age.
Prolactin causes an increase in the binding activity of transcription factors, nuclear factor kappa B, and interferon regulatory factor 1 (IRF1), which are known to promote the secretion of IL 12 and TNF alpha. These data suggest that PRL promotes pro-inflammatory immune responses through NF Kappa B and IRF1 .
The expression and synthesis of prolactin has been demonstrated in thymocytes, T cells, B cells and monocytes, the PRL receptor is expressed in both lymphocytes and monocytes, which suggests that the hormone can act in an autocrine or paracrine way, in a similar to cytokines . So, in an active state, high levels of pro-inflammatory cytokines (IL-6) could activate the pituitary to produce excessive amounts of PRL .
Several clinical and laboratory indices have been proposed to assess disease activity. One of the strategies to score activity is the use of the systemic activity index of lupus erythematosus disease (SLEDAI), the application of this index can be difficult worldwide. For example, complement determination and other immunological tests are not widely available, these reasons were taken into account when developing a new instrument, the MEX SLEDAI, a scale that we used in the population of this study due to the characteristics of our population this represents represents one of the strengths of this study since it is easy to apply, another strength is the usefulness of identifying hyperprolactinemia as a marker of active lupus is to carry out actions that slow its progression using it as a tool to identify those patients with active disease being a accessible laboratory in our center.
The most important limitation of this study was that due to the health contingency a greater number of patients was not reached, because the patients did not show up for their medical consultation or the control laboratory studies were not carried out. An important area of opportunity would be the continuity or extension of the study in months after the pandemic to reach a representative sample of patients with lupus and thus have a greater possibility of detecting patients with active disease, since the study of prolactin in the population with Active SLE could have a great impact on treatment and timely evaluation.