Macroprolactin; a frequent cause of misdiagnosed hyperprolactinemia in clinical practice

Area of Science:

• Endocrinology
• Clinical Chemistry

Background:

• Macroprolactin is a common cause of misdiagnosis and inappropriate treatment in hyperprolactinemia.
• Technical difficulties hinder macroprolactin identification, leading to unawareness among clinicians and labs.
• Interference of macroprolactin in prolactin assays is a significant clinical challenge.

Purpose of the Study:

• To review the current understanding of macroprolactinemia.
• To highlight the diagnostic challenges and clinical implications of macroprolactin.
• To emphasize the need for updated diagnostic and pathophysiological knowledge.

Main Methods:

• A comprehensive literature search was performed.
• Databases searched included PubMed Central and the National Library of Medicine.
• Relevant books and journals were also consulted.

Main Results:

• Macroprolactin is a non-bioactive prolactin isoform, typically a prolactin monomer bound to an IgG molecule.
• It exhibits prolonged clearance, similar to immunoglobulins.
• This isoform is clinically non-reactive but interferes with immunological prolactin assays.

Conclusions:

• There is a critical need to enhance understanding of macroprolactinemia.
• Recent advancements in diagnosis and pathophysiology require exploration.
• Improving patient care necessitates better awareness and diagnostic strategies for macroprolactin.