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[Usefulness of Polyethylene-Glycol Precipitation As a Screening Method for Macroprolactinemia]

Asuka Yamakami, Ryuya Takahashi, Chizumi Fukazawa

    Rinsho Byori. the Japanese Journal of Clinical Pathology
    |January 5, 2019
    PubMed

    Insights

    Macroprolactin, a complex of prolactin (PRL) with IgG, can cause misdiagnosis. Polyethylene-glycol (PEG) precipitation effectively screens for macroprolactinemia, identifying cases missed by standard tests.

    Area of Science:

    • Clinical Chemistry
    • Endocrinology
    • Immunology

    Background:

    • Macroprolactin is a complex of monomeric prolactin (PRL) with IgG, often biologically inactive.
    • Its presence can lead to diagnostic confusion and misdiagnosis in clinical practice.
    • Polyethylene-glycol (PEG) precipitation is a recognized method for screening macroprolactinemia.

    Purpose of the Study:

    • To evaluate the efficacy of the PEG precipitation method for screening macroprolactinemia.
    • To determine the prevalence of macroprolactinemia in a clinical sample population.
    • To assess the diagnostic utility of PRL recovery percentage after PEG precipitation.

    Main Methods:

    • Applied PEG precipitation to 200 samples with ordered PRL tests.
    • Calculated PRL recovery percentage (mean ± SD = 65.0±11.2%).
    • Established a threshold for macroprolactin presence (PRL recovery < 42.5%).

    Main Results:

    • Macroprolactinemia prevalence was 4.5% (9/197) in the total sample group.
    • In cases of hyperprolactinemia, macroprolactinemia prevalence was 9.5% (2/21).
    • PRL recovery below mean - 2SD (42.5%) indicated the presence of macroprolactin.

    Conclusions:

    • PEG precipitation is a valuable screening tool for macroprolactinemia.
    • Implementing PEG screening can help prevent misdiagnosis of hyperprolactinemic conditions.
    • Routine screening for macroprolactin is recommended to improve diagnostic accuracy.

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