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Macroprolactin screening in 464 patients with hyperprolactinaemia.

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Macroprolactinaemia is common, even with high prolactin levels. Reporting post-PEG prolactin and recovery percentage aids hyperprolactinaemia management.

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Area of Science:

  • Endocrinology
  • Clinical Chemistry

Background:

  • Macroprolactinaemia diagnosis typically relies on polyethylene glycol (PEG) precipitation.
  • Current laboratory policies for macroprolactin screening require revision.

Purpose of the Study:

  • To review laboratory data on prolactin and macroprolactin screening using PEG precipitation.
  • To revise local policies for reflex screening and reporting of macroprolactin in hyperprolactinaemia.

Main Methods:

  • Retrospective review of paired prolactin results (pre- and post-PEG precipitation) from 464 patients.
  • Data included clinician-requested and reflex PEG precipitation tests.

Main Results:

  • Prolactin recovery after PEG precipitation was highly variable (3.7–97.7%).
  • Distinct patterns of prolactin recovery were observed in patients with and without true hyperprolactinaemia.
  • Macroprolactinaemia and true hyperprolactinaemia co-existed in 1.1% of patients.

Conclusions:

  • Macroprolactinaemia is prevalent and can occur with very high serum prolactin concentrations.
  • No specific pre-PEG prolactin concentration reliably excludes macroprolactinaemia.
  • Reporting post-PEG prolactin and recovery percentage is crucial for interpreting and managing hyperprolactinaemia.