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[Macroprolactin detection: a new approach].

R Sapin1, F Gasser, E Fischbach

  • 1Laboratoire universitaire de biophysique, Unité d'analyses endocriniennes, CNRS UPRES-A7004, Université Louis-Pasteur, Faculté de médecine, 67085 Strasbourg cedex.

Annales De Biologie Clinique
|December 1, 2000
PubMed
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Macroprolactin, a prolactin-immunoglobulin complex, can interfere with hyperprolactinemia diagnosis. A two-assay ratio method shows good agreement with PEG precipitation for detecting macroprolactin, aiding clinical assessment.

Area of Science:

  • Clinical Chemistry
  • Endocrinology
  • Laboratory Medicine

Background:

  • Macroprolactin, a complex of prolactin with immunoglobulins (IgG), exhibits limited biological activity.
  • Immunoassays for prolactin demonstrate variable reactivity with macroprolactin, complicating hyperprolactinemia diagnosis.
  • Macroprolactin should be considered in the differential diagnosis of elevated prolactin levels.

Purpose of the Study:

  • To compare polyethyleneglycol (PEG) precipitation, a screening test for macroprolactin, with a novel ratio method using two prolactin assays.
  • To evaluate the utility of the Elecsys/Centaur prolactin assay ratio in identifying macroprolactin compared to PEG precipitation.
  • To assess the agreement between the PEG test and the assay ratio method for macroprolactin detection.

Main Methods:

Related Experiment Videos

  • Comparison of PEG precipitation test results with the ratio of prolactin measurements from Elecsys (high macroprolactin reactivity) and Centaur (low macroprolactin reactivity) assays.
  • Analysis of 59 PEG-negative, 35 PEG-positive, and 5 PEG-grey zone samples.
  • Evaluation of the Elecsys/Centaur ratio in relation to PEG precipitation results.

Main Results:

  • The Elecsys/Centaur ratio showed good agreement with the PEG test, correctly identifying most macroprolactin-positive and negative samples.
  • Among PEG-positive samples, 33 out of 35 showed an increased ratio (>1.45).
  • In the PEG-grey zone, the ratio method provided additional discriminatory information, with 4 out of 5 samples showing ratios outside the reference range.

Conclusions:

  • The Elecsys/Centaur prolactin assay ratio is a valuable method for detecting macroprolactin, complementing PEG precipitation.
  • The ratio method is particularly useful for samples with equivocal PEG test results.
  • Reevaluation of the Centaur prolactin reference range using samples without macroprolactin is recommended.