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Macroprolactinemia: predictability on clinical basis and detection by PEG precipitation with two different
P Amadori1, C Dilberis, A Marcolla
1Outpatient Endocrinology Service-A.P.S.S., Trento, Italy. amadoripierluigi@libero.it
Journal of Endocrinological Investigation
|May 13, 2003
Summary
Macroprolactinemia, a form of hyperprolactinemia, can cause diagnostic issues. Polyethylene Glycol (PEG) precipitation helps detect macroprolactin (PRL) and is adaptable for clinical immunoassays.
Area of Science:
- Endocrinology
- Clinical Chemistry
- Immunology
Background:
- Human serum prolactin (PRL) exists as monomeric, big, and big, big PRL (macroprolactinemia) forms.
- Macroprolactin, often complexed with IgG, has reduced biological activity but interferes with immunoassays, causing diagnostic challenges.
- Polyethylene Glycol (PEG) precipitation is a method to detect macroprolactin, but its applicability varies across immunoassay platforms.
Purpose of the Study:
- To clinically predict macroprolactinemia.
- To assess the feasibility of using PEG precipitation with the Abbott AxSYM analyzer, comparing it to the Roche Elecsys system.
- To provide guidance for accurate PRL measurement in cases of suspected macroprolactinemia.
Main Methods:
- Clinical and imaging data were used to classify 34 hyperprolactinemic women into functional hyperprolactinemia, pituitary lesions, probable macroprolactinemia, and unclassifiable groups, plus a control group.
- Prolactin (PRL) levels were measured using both Roche Elecsys and Abbott AxSYM analyzers before and after PEG serum treatment.
- PEG precipitation was adapted for the Abbott AxSYM by treating calibration standards, enabling comparable results to the Roche Elecsys.
Main Results:
- Macroprolactinemia was identified in 11/12 patients in the probable macroprolactinemia group and 5/7 in the unclassifiable group.
- Fewer cases of macroprolactinemia were found in the functional hyperprolactinemia (1/7) and pituitary lesions (1/8) groups.
- PEG precipitation proved effective on the Abbott AxSYM after adapting the calibration standards, yielding results consistent with the Roche Elecsys.
Conclusions:
- Clinical assessment can help predict macroprolactinemia, with higher prevalence in specific patient groups.
- Adapted PEG precipitation is a viable method for macroprolactin detection on the Abbott AxSYM, aligning with Roche Elecsys performance.
- Accurate diagnosis in hyperprolactinemia requires considering macroprolactinemia and calculating monomeric PRL levels alongside total PRL measurements.