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Macroprolactinemia: a new cause of hyperprolactinemia
1Department of Pharmacology, Kansai Medical University, Osaka 570-8506, Japan. hattori@takii.kmu.ac.jp
Journal of Pharmacological Sciences
|August 2, 2003
Summary
Idiopathic hyperprolactinemia is often caused by macroprolactinemia, a condition where prolactin (PRL) forms large complexes. Identifying macroprolactinemia prevents unnecessary treatments for patients with high PRL levels.
Area of Science:
- Endocrinology
- Reproductive Medicine
- Clinical Biochemistry
Background:
- Hyperprolactinemia, elevated prolactin levels, has various causes including pituitary adenomas and medications.
- Idiopathic hyperprolactinemia is diagnosed when the cause is unknown, leading to extensive investigations and treatments.
- Macroprolactinemia, characterized by large prolactin complexes (>150 kDa), is increasingly recognized as a cause of hyperprolactinemia.
Purpose of the Study:
- To investigate the role of macroprolactinemia and anti-prolactin (PRL) autoantibodies in idiopathic hyperprolactinemia.
- To determine the clinical characteristics and implications of macroprolactinemia in patients with unexplained hyperprolactinemia.
Main Methods:
- Analysis of circulating prolactin (PRL) forms, focusing on the prevalence of macroprolactinemia.
- Detection of anti-PRL autoantibodies in patients diagnosed with idiopathic hyperprolactinemia.
- Clinical evaluation of patients with macroprolactinemia, including symptom assessment and reproductive outcomes.
Main Results:
- Macroprolactinemia is a significant contributor to cases previously diagnosed as idiopathic hyperprolactinemia.
- Anti-PRL autoantibodies were identified as a primary cause of macroprolactinemia.
- Patients with macroprolactinemia, particularly those with anti-PRL autoantibodies, were often asymptomatic and capable of achieving pregnancy despite elevated PRL levels.
Conclusions:
- Identifying macroprolactinemia is crucial for accurate diagnosis and management of hyperprolactinemia.
- Distinguishing macroprolactinemia from other causes prevents unnecessary radiological examinations, bromocriptine treatment, and surgical interventions.
- Recognition of macroprolactinemia, especially due to anti-PRL autoantibodies, can spare patients from extensive and potentially unwarranted medical interventions.