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The natural history of macroprolactinaemia

Naoki Hattori1, Takashi Adachi, Takashi Ishihara

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

European Journal of Endocrinology
|January 17, 2012
PubMed
Abstract

Insights

Macroprolactinaemia, characterized by high molecular weight prolactin (PRL), appears to be a chronic condition. This study found it persists over time and may lead to hyperprolactinaemia, particularly in those with increasing anti-PRL autoantibodies.

Area of Science:

  • Endocrinology
  • Reproductive Medicine

Background:

  • Macroprolactinaemia is defined by serum prolactin (PRL) predominantly consisting of large molecular weight PRL (macroPRL).
  • Understanding the natural history of macroprolactinaemia is crucial for clinical management.

Purpose of the Study:

  • To investigate the long-term clinical course and biochemical characteristics of macroprolactinaemia.
  • To determine if macroprolactinaemia is a stable condition or if it evolves over time.

Main Methods:

  • A longitudinal study evaluated 27 subjects with macroprolactinaemia and 627 controls over 4 years.
  • MacroPRL levels, serum PRL concentrations, and anti-PRL autoantibody titers were assessed using polyethylene glycol (PEG) precipitation, gel filtration, and binding assays.

Main Results:

  • All macroprolactinaemic subjects maintained persistent macroprolactinaemia without elevated free PRL over 4 years.
  • While total and free PRL levels remained stable, five initially normoprolactinaemic subjects developed hyperprolactinaemia with increased anti-PRL autoantibodies.
  • One hyperprolactinaemic subject showed decreased PRL levels correlating with reduced anti-PRL autoantibody titers.

Conclusions:

  • Macroprolactinaemia is likely a chronic endocrine condition that can manifest before middle age.
  • The condition may predispose individuals to developing hyperprolactinaemia, influenced by autoantibody dynamics.

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