OBJECTIVES: Macroprolactin is a complex of prolactin (PRL) and IgG and may account for a significant proportion of cases of 'idiopathic hyperprolactinaemia'. In this study, we sought to determine the prevalence and clinical features of macroprolactinaemia in patients diagnosed with hyperprolactinaemia in our region, with a view to determining how patients with macroprolactinaemia should be investigated and managed. PATIENTS AND METHODS: An Immuno-1 automated immunoassay system with polyethylene glycol (PEG) precipitation was used to identify macroprolactin, with a recovery of </= 50% taken as indicating significant macroprolactinaemia. Macroprolactin was found in 58 (21%) of 273 patients with a total PRL > 700 mU/l. The clinical records of 51 (44 female) were available for retrospective review. RESULTS: The mean (range) age of patients was 39.5 (18-82) years. The median (range) concentrations for the various forms of PRL were: total PRL 1130 mU/l (728-5116), monomeric PRL 240 mU/l (50-656) and macroprolactin 895 mU/l (381-4854). Classical symptoms of hyperprolactinaemia were present in 39% of patients, although in many there were other possible explanations for their symptomatology. Pituitary adenomas were identified in six out of 36 people who underwent neuroimaging. Five of these patients had a microadenoma and one had a 10-mm macroadenoma (although, in this patient macroprolactin was identified after the discovery of the tumour). There was no relationship between macroprolactin concentrations and the presence of hyperprolactinaemic symptoms or neuroimaging abnormalities. CONCLUSIONS: Macroprolactinaemia is a common occurrence in patients with hyperprolactinaemia, but associated symptomatology may not necessarily be linked. The neuroimaging abnormalities were also probably incidental findings and it is questionable whether neuroimaging is necessary when significant macroprolactinaemia is identified and the concentration of monomeric PRL is not elevated (using the Immuno-1 assay system, following PEG precipitation).
OBJECTIVES: Macroprolactin is a complex of prolactin (PRL) and IgG and may account for a significant proportion of cases of 'idiopathic hyperprolactinaemia'. In this study, we sought to determine the prevalence and clinical features of macroprolactinaemia in patients diagnosed with hyperprolactinaemia in our region, with a view to determining how patients with macroprolactinaemia should be investigated and managed. PATIENTS AND METHODS: An Immuno-1 automated immunoassay system with polyethylene glycol (PEG) precipitation was used to identify macroprolactin, with a recovery of </= 50% taken as indicating significant macroprolactinaemia. Macroprolactin was found in 58 (21%) of 273 patients with a total PRL > 700 mU/l. The clinical records of 51 (44 female) were available for retrospective review. RESULTS: The mean (range) age of patients was 39.5 (18-82) years. The median (range) concentrations for the various forms of PRL were: total PRL 1130 mU/l (728-5116), monomeric PRL 240 mU/l (50-656) and macroprolactin 895 mU/l (381-4854). Classical symptoms of hyperprolactinaemia were present in 39% of patients, although in many there were other possible explanations for their symptomatology. Pituitary adenomas were identified in six out of 36 people who underwent neuroimaging. Five of these patients had a microadenoma and one had a 10-mm macroadenoma (although, in this patient macroprolactin was identified after the discovery of the tumour). There was no relationship between macroprolactin concentrations and the presence of hyperprolactinaemic symptoms or neuroimaging abnormalities. CONCLUSIONS: Macroprolactinaemia is a common occurrence in patients with hyperprolactinaemia, but associated symptomatology may not necessarily be linked. The neuroimaging abnormalities were also probably incidental findings and it is questionable whether neuroimaging is necessary when significant macroprolactinaemia is identified and the concentration of monomeric PRL is not elevated (using the Immuno-1 assay system, following PEG precipitation).
Authors: L Vilar; M C Freitas; L A Naves; L A Casulari; M Azevedo; R Montenegro; A I Barros; M Faria; G C Nascimento; J G Lima; L H Nóbrega; T P Cruz; A Mota; A Ramos; A Violante; A Lamounier Filho; M R Gadelha; M A Czepielewski; A Glezer; M D Bronstein Journal: J Endocrinol Invest Date: 2008-05 Impact factor: 4.256
Authors: Erzsébet Toldy; Zoltán Löcsei; István Szabolcs; Miklós I Góth; Pál Kneffel; Dominika Szöke; Gábor L Kovács Journal: Endocrine Date: 2003-12 Impact factor: 3.633
Authors: Lucio Vilar; Luciana Ansaneli Naves; Luiz Augusto Casulari; Monalisa Ferreira Azevedo; José Luciano Albuquerque; Fabiano Marcel Serfaty; Flavia R Pinho Barbosa; Antonio Ribeiro de Oliveira; Renan Magalhães Montenegro; Renan Magalhães Montenegro; Alberto José Santos Ramos; Manuel Dos Santos Faria; Nina Rosa C Musolino; Monica R Gadelha; Cesar Luiz Boguszewski; Marcello D Bronstein Journal: Pituitary Date: 2010-09 Impact factor: 4.107
Authors: Noor Azlin Azraini Che Soh; Najib Majdi Yaacob; Julia Omar; Aniza Mohammed Jelani; Noorazliyana Shafii; Tuan Salwani Tuan Ismail; Wan Norlina Wan Azman; Anis Kausar Ghazali Journal: Int J Environ Res Public Health Date: 2020-11-06 Impact factor: 3.390
Authors: Atanaska Elenkova; Zdravka Abadzhieva; Nikolai Genov; Vladimir Vasilev; Georgi Kirilov; Sabina Zacharieva Journal: Case Rep Endocrinol Date: 2013-01-15