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Macroprolactin on the Advia Centaur: experience with 409 patients over a three-year period

N F Jassam1, A Paterson, C Lippiatt

  • 1Department of Clinical Biochemistry, Leeds Teaching Hospitals NHS Trust, Leeds General Infirmary, UK. nuthar.jassam@leedsth.nhs.uk

Annals of Clinical Biochemistry
|October 24, 2009
PubMed
Abstract

Insights

Polyethylene glycol (PEG) precipitation is crucial for accurately diagnosing hyperprolactinaemia with assays like the Advia Centaur, which have low macroprolactin (MPRL) reactivity. This screening helps prevent misdiagnosis in patients with elevated prolactin levels.

Area of Science:

  • Clinical Chemistry
  • Endocrinology
  • Laboratory Medicine

Background:

  • Macroprolactin (MPRL) interferes with prolactin assays, potentially causing misdiagnosis and improper patient management.
  • Prolactin assay variability in MPRL detection necessitates careful analytical considerations.
  • The Advia Centaur assay shows low reactivity with MPRL, highlighting the need for specific diagnostic protocols.

Purpose of the Study:

  • To evaluate the necessity of polyethylene glycol (PEG) precipitation for hyperprolactinaemia analysis using the Advia Centaur assay.
  • To determine the prevalence of MPRL as a cause of hyperprolactinaemia in a clinical setting.
  • To assess the clinical significance of elevated monomeric prolactin in patients with MPRL.

Main Methods:

  • Analysis of 464 hyperprolactinaemic samples collected over three years.
  • Screening for MPRL using a PEG precipitation protocol.
  • Comparison of monomeric prolactin concentration post-PEG precipitation with a reference range.

Main Results:

  • MPRL accounted for 4% of hyperprolactinaemia cases (16/409) over the study period.
  • Nine individuals with MPRL also exhibited elevated monomeric prolactin levels.
  • The Advia Centaur assay demonstrated low reactivity with MPRL.

Conclusions:

  • PEG screening remains essential for prolactin assays with low MPRL reactivity, such as the Advia Centaur.
  • Local reference ranges for monomeric prolactin are recommended for accurate interpretation post-PEG precipitation.
  • Accurate MPRL detection is vital for appropriate hyperprolactinaemia diagnosis and management.

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