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Related Experiment Video

Updated: May 7, 2026

Comprehensive Profiling of Dopamine Regulation in Substantia Nigra and Ventral Tegmental Area
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Comprehensive Profiling of Dopamine Regulation in Substantia Nigra and Ventral Tegmental Area

Published on: August 10, 2012

Determination of prolactin: the macroprolactin problem.

Michael Fahie-Wilson1, Thomas P Smith

  • 1Department of Clinical Chemistry, Southend Hospital, Westcliff-on-Sea, Essex SSO ORY, United Kingdom.

Best Practice & Research. Clinical Endocrinology & Metabolism
|October 8, 2013
PubMed
Summary

Macroprolactin, a common interference in prolactin tests, can lead to misdiagnosis. Identifying macroprolactinaemia through polyethylene glycol (PEG) screening is crucial for accurate reproductive disorder assessment.

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Area of Science:

  • Clinical Chemistry
  • Reproductive Endocrinology
  • Immunodiagnostics

Background:

  • Elevated serum prolactin is common in reproductive disorders, affecting up to 17% of patients.
  • Automated immunoassays are standard for prolactin measurement but susceptible to interference.
  • Macroprolactin, a prolactin/IgG complex, can cause falsely high prolactin levels without clinical significance.

Purpose of the Study:

  • To highlight the diagnostic challenge posed by macroprolactin in hyperprolactinemic patients.
  • To emphasize the clinical irrelevance of macroprolactin despite its reactivity in immunoassays.
  • To advocate for improved diagnostic strategies to differentiate true hyperprolactinemia from macroprolactinaemia.

Main Methods:

  • Review of current immunoassay methodologies for prolactin quantification.
Keywords:
hyperprolactinaemiaimmunoassay interferencemacroprolactinmacroprolactinaemiapolyethylene glycol (PEG) screeningprolactin

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Last Updated: May 7, 2026

Comprehensive Profiling of Dopamine Regulation in Substantia Nigra and Ventral Tegmental Area
09:54

Comprehensive Profiling of Dopamine Regulation in Substantia Nigra and Ventral Tegmental Area

Published on: August 10, 2012

  • Discussion of polyethylene glycol (PEG) precipitation as a method for macroprolactin detection.
  • Analysis of the clinical implications of macroprolactinaemia.

    • Main Results:

    • Macroprolactin is a high molecular mass complex that interferes with standard prolactin immunoassays.
    • Macroprolactinaemia, characterized by elevated macroprolactin, can lead to misdiagnosis and mismanagement.
    • PEG precipitation effectively separates monomeric prolactin from macroprolactin, enabling accurate bioactive prolactin measurement.

    Conclusions:

    • Macroprolactinaemia can be accurately identified using PEG screening of sera with elevated total prolactin.
    • Clinical laboratories and manufacturers should implement strategies to mitigate macroprolactin interference.
    • Clinicians must be aware of macroprolactin and request PEG screening to avoid misdiagnosis in hyperprolactinemic patients.