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[Macroprolactinemia in the differential diagnosis of hyperprolactinemia]

Erzsébet Toldy1, Zoltán Löcsei, István Szabolcs

  • 1Vas Megye és Szombathely MJV Markusovszky Kórháza, Központi Laboratórium, Szombathely. salamon7@elender.hu

Orvosi Hetilap
|December 10, 2003
PubMed
Abstract

Insights

Macroprolactin is not found in mild hyperprolactinemia and its prevalence increases with age. Clinical signs and pituitary abnormalities are less common in macroprolactinemia compared to true hyperprolactinemia.

Area of Science:

  • Endocrinology
  • Clinical Chemistry

Context:

  • Hyperprolactinemia can be caused by biologically active prolactin or inactive macroprolactin.
  • Standard prolactin assays show variable reactions with macroprolactin, complicating diagnosis.

Purpose:

  • To analyze clinical signs of hyperprolactinemia in macroprolactinemia versus true hyperprolactinemia.
  • To determine the prevalence of macroprolactinemia in hyperprolactinemic females.

Summary:

  • Macroprolactinemia was identified in 23% of hyperprolactinemic females, with prevalence increasing with age.
  • Clinical signs like pituitary microadenoma, galactorrhea, and infertility were less frequent in macroprolactinemia.
  • True hyperprolactinemia co-occurred in 15.3% of macroprolactinemia cases; polycystic ovary syndrome was more common in true hyperprolactinemia.

Impact:

  • Macroprolactin does not occur in mild hyperprolactinemia; screening is recommended for prolactin levels > 700 mlU/L.
  • Distinguishing macroprolactinemia from true hyperprolactinemia is crucial to avoid diagnostic and therapeutic errors.
  • Findings aid in understanding the clinical presentation and prevalence of macroprolactinemia in women.

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