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Macroprolactinemia revisited: a study on 106 patients
Sophie Vallette-Kasic1, Isabelle Morange-Ramos, Adel Selim
1Department of Endocrinology, Centre Hospitalier Universitaire Timone, 13385 Marseille Cedex 5.
The Journal of Clinical Endocrinology and Metabolism
|February 12, 2002
Summary
Macroprolactinemia, a common cause of hyperprolactinemia, affects at least 10% of patients. While fertility is often preserved, symptoms persist, necessitating accurate diagnostic methods to avoid unnecessary treatments.
Area of Science:
- Endocrinology
- Reproductive Medicine
- Clinical Chemistry
Background:
- Macroprolactinemia, characterized by high molecular weight prolactin (PRL), is recognized in hyperprolactinemic patients with preserved fertility.
- Investigating hyperprolactinemia often involves differentiating macroprolactinemia from other causes.
Purpose of the Study:
- To determine the incidence and clinical characteristics of macroprolactinemia in a hyperprolactinemic patient cohort.
- To evaluate the impact of macroprolactinemia on fertility, pregnancy, and response to treatment.
Main Methods:
- Serum PRL chromatography was performed on 368 patients investigated for hyperprolactinemia.
- A prospective study compared 106 patients with macroprolactinemia to 262 hyperprolactinemic patients with normal PRL elution patterns.
- Pituitary MRI was conducted on a subset of patients.
Main Results:
- Macroprolactinemia was identified in at least 10% of the hyperprolactinemic population.
- Patients exhibited persistent hyperprolactinemia symptoms despite maintained fertility and uneventful pregnancies.
- PRL levels were typically stable, with some normalization on dopaminergic therapy and increases during pregnancy.
Conclusions:
- Macroprolactinemia is a significant contributor to hyperprolactinemia, impacting clinical presentation and management.
- Accurate diagnostic tools for macroprolactinemia are crucial to prevent unnecessary hormonal and radiological investigations.
- Further research into the long-term implications and optimal management strategies for macroprolactinemia is warranted.
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