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Macroprolactinaemia: prevalence and aetiologies in a large group of hospital workers

Naoki Hattori1, Takashi Ishihara, Yasuhiko Saiki

  • 1Department of Pharmacology, Ritsumeikan University, 1-1-1 Nojihigashi, Kusatsu-city, Shiga, Japan. hattorin@fc.ritsumei.ac.jp

Clinical Endocrinology
|June 3, 2009
PubMed
Abstract

Insights

Macroprolactinaemia, a common cause of hyperprolactinaemia, is often misdiagnosed. This study found prolactin-IgG complexes, mainly from autoantibodies, are the primary cause in healthy individuals.

Area of Science:

  • Endocrinology
  • Clinical Chemistry

Background:

  • Macroprolactinaemia is a significant cause of hyperprolactinaemia, frequently leading to misdiagnosis and inappropriate treatment.
  • The underlying aetiologies of macroprolactinaemia remain unclear, necessitating further investigation.

Purpose of the Study:

  • To determine the prevalence of macroprolactinaemia in a healthy population.
  • To investigate the mechanisms responsible for the development of macroprolactin.

Main Methods:

  • An observational study was conducted using excess sera from hospital workers in Japan.
  • Macroprolactinaemia screening was performed using the polyethylene glycol (PEG) precipitation method.
  • Binding studies were employed to examine sera containing macroprolactin for potential aetiologies.

Main Results:

  • Macroprolactinaemia was diagnosed in 3.68% (49/1330) of subjects.
  • Subjects with macroprolactinaemia exhibited a significantly higher frequency of hyperprolactinaemia (30.6%) compared to those without (2.26%).
  • Prolactin-IgG complexes, primarily involving anti-prolactin autoantibodies, were identified as the major cause of macroprolactin, with glycosylation, aggregation, and binding also contributing.

Conclusions:

  • Macroprolactinaemia is a prevalent condition in healthy populations, contributing to hyperprolactinaemia.
  • The primary aetiology involves prolactin-IgG complexes, largely driven by anti-prolactin autoantibodies.
  • Other minor complex prolactin species also play a role in macroprolactin formation.

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