ISSN 1470-3947 (print) | ISSN 1479-6848 (online)

Endocrine Abstracts (2008) 16 P474

Macroprolactinaemia: a clinical problem

Aldona Kowalska, Danuta Gasior-Perczak, Iwona Palyga & Anna Sluszniak


Holycross Cancer Centre, Kielce, Poland.


Introduction: Prolactin is a hormone which is characterized with a high structural and functional polymorphism. Macroprolactin is one of the form of prolactin - it is a complex of monomeric prolactin and immunoglobulin. Macroprolactin is characterized with immunoreactivity and probably the lack of biological activity.

Purpose: The main purpose of our study was to estimate the frequency of macroprolactin appearance among the patients with hyperpronactinaemia but also analysis of clinical and biochemiacal symptoms of hyperprolactinaemia.

Material: The study involved 125 patients diagnosed of hyperprolactinaemia in term from January to December 2006.

Method: The concentration of total prolactin, macroprolactin (using the method of polyethylene glycol- PEG- precipitation) and recovery test of prolactin was marked to all patients. Macroprolactinaemia was diagnosed in case of recovery test below 40%. The frequency of clinical symptoms were evaluated in the patients.

Results: Among 125 patients with hyperprolactinaemia–macroprolactinaemia was diagnosed in 43 (34.4%).

Number of patientsTotal PRL mIU/lFree PRL mIU/mlMRIClinical symptomsOligomenorrheaGalactorrheaAmenorrhea/galactorrhea
43 (34.4%)1658 657–5900348 116–2514Yes/no 35/8 2 tumors11 (25.5%)623

Among patients with clinical symptoms diagnosis of

– PCOS was established in 5 of 6 with oligomenorrhea (with free prolactin concentration- 245,142, 163, 157, 207 mIU/l respectively)

– hypergonadotropic hypogonadism in 1 of 6 with oligomenorrhea (free PRL-260)

– selective galactorrhea in 2 patients with galactorrhea (free PRL- 597, 643)

– hipogonadotropic hypogonadism in 3 patients with galactorrhea–amenorrhea with free PRL concentration of 2514, 1062, 928 mIU/l respectively.

Conclusion:
1. Among patients with hyperprolactinaemia macroprolactinaemia is accounted for 34.4%.

2. Clinical symptoms do not appear in case of macroprolactinaemia.

3. Irregular menstruations and galactorrhea are results of coincidence of monomeric hyperprolactinaemia or other endocrine disorders (PCOS, premature ovarian failure)

4. Macroprolactin level measurement should be taken in every case of hyperprolactinaemia.

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