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[The diagnostic value of macroprolactin in hyperprolactinemia]
Abstract:
Macroprolactinemia (MP) in which there is a discrepancy between prolactin (P) levels and clinical symptoms has recently generated great interest among physicians of various specialties since not the whole of P is biologically active. The diagnosis of this condition is a topical problem. The purpose of the investigation was to detect high molecular-weight or big big P in patients with hyperprolactinemia (HP) of various genesis and to define its clinical importance. A hundred and one females with HP (P > 700 mU/l) were examined. In each patient, biologically active monomeric P was measured via treatment of polyethylene glycol (PEG) 6000. MP was detected in 23% of the examinees. Among them, only 11 females had clinical symptoms of the disease: 72.7% complained about menstrual irregularities; galactorrhea and headache were observed in 18.3 and 9.0%, respectively. The remaining 12 females had no clinical symptoms of HP. MP in which the clinical symptoms are feebly marked has been found to be not a rare condition. The determination of big big P in HP is of diagnostic value. It is recommended that the serum separation diagnostic technique using PEG should be made routine in the examination of patients with HP, particularly in the discrepancy of biochemical and clinical data and in idiopathic HP.
Insights
Macroprolactinemia, a condition with high prolactin levels but few symptoms, is common. Detecting big big prolactin using PEG is crucial for accurate hyperprolactinemia diagnosis.
Area of Science:
- Endocrinology
- Clinical Chemistry
Context:
- Hyperprolactinemia (HP) diagnosis can be challenging due to discrepancies between prolactin (P) levels and clinical presentation.
- Macroprolactinemia (MP) accounts for a significant portion of HP, involving biologically inactive high molecular-weight prolactin.
- The clinical significance of MP, especially when symptoms are mild, requires further elucidation.
Purpose:
- To detect high molecular-weight prolactin (big big P) in patients with hyperprolactinemia of various origins.
- To determine the clinical importance and diagnostic value of big big prolactin in hyperprolactinemia.
- To assess the prevalence of MP in females with elevated prolactin levels.
Summary:
- A study examined 101 females with hyperprolactinemia (prolactin > 700 mU/l).
- Biologically active monomeric prolactin was measured using polyethylene glycol (PEG) 6000 treatment.
- Macroprolactinemia was identified in 23% of patients, with only 11 exhibiting clear clinical symptoms.
Impact:
- Macroprolactinemia is a frequent finding, often presenting with subtle or absent clinical symptoms.
- The determination of big big prolactin using PEG is valuable for diagnosing hyperprolactinemia.
- Routine use of PEG separation is recommended for patients with HP, especially in cases of idiopathic HP or discordant clinical and biochemical findings.
