This Article Full Text Full Text (PDF) Submit a related Letter to the Editor Purchase Article View Shopping Cart Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Copyright Permission Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Vallette-Kasic, S. Articles by Brue, T. Search for Related Content PubMed PubMed Citation Articles by Vallette-Kasic, S. Articles by Brue, T. Pubmed/NCBI databases Compound via MeSH Substance via MeSH

Macroprolactinemia Revisited: A Study on 106 Patients

Departments of Endocrinology (S.V.-K., I.M.-R., A.S., P.J., T.B.) and Medical Information (S.M.), Centre Hospitalier Universitaire Timone, 13385 Marseille Cedex 5; and Laboratoire Interactions Cellulaires Neuro-Endocriniennes (S.V.-K., I.M.-R., G.G., A.E., P.J., T.B.), Centre National de la Recherche Scientifique Unité Mixte de Recherche 6544, and Laboratoire de Transfert d’Oncologie Biologique (P.-M.M.), Institut Fédératif de Recherche Jean Roche, 13916 Marseille Cedex 20, France

Address all correspondence and requests for reprints to: Thierry Brue, M.D., Ph.D., Hôpital de la Timone, 264 rue St Pierre, 13385 Marseille Cedex 5, France. E-mail: tbrue{at}ap-hm.fr

Abstract

The predominance of high molecular weight PRL, or macroprolactinemia, has long been known in hyperprolactinemic patients with maintained fertility. Among 1,106 consecutive patients investigated for hyperprolactinemia in our center over a 10-yr period, serum PRL chromatography was performed in 368 cases because of discordant clinical, biological, or neuroradiological findings. We prospectively studied the 106 patients with macroprolactinemia (96 women, 6 men, 4 children) and compared them with the 262 hyperprolactinemic patients with a normal PRL elution pattern. We concluded the following: 1) the incidence of macroprolactinemia in our hyperprolactinemic population was at least 10%; 2) despite preserved fertility with uneventful pregnancies, some of the usual symptoms of hyperprolactinemia were present; 3) mean PRL values were 61 ± 66 µg/liter (range, 20–663) and exceeded 100 µg/liter in 8.5% of patients; 4) PRL levels usually remained stable over time; 5) on dopaminergic therapy, PRL returned to normal in 21of 45 treated patients; 6) during follow-up of 7 pregnancies, PRL increased to supraphysiological levels in 5; and 7) pituitary magnetic resonance imaging was normal in 78% of patients or revealed diverse pituitary lesions, including adenomas (n = 5). A diagnostic method for macroprolactinemia should be available to all centers to avoid unnecessary hormonal or radiological investigations and treatments.

This article has been cited by other articles:

				N. Hattori, Y. Nakayama, K. Kitagawa, T. Li, and C. Inagaki Development of Anti-PRL (Prolactin) Autoantibodies by Homologous PRL in Rats: A Model for Macroprolactinemia Endocrinology, May 1, 2007; 148(5): 2465 - 2470. [Abstract] [Full Text] [PDF]

				N Hattori, Y Nakayama, K Kitagawa, T Ishihara, Y Saiki, and C Inagaki Anti-prolactin (PRL) autoantibody-binding sites (epitopes) on PRL molecule in macroprolactinemia. J. Endocrinol., August 1, 2006; 190(2): 287 - 293. [Abstract] [Full Text] [PDF]

				A. Glezer, C. R. J. Soares, J. G. Vieira, D. Giannella-Neto, M. T. C. P. Ribela, V. Goffin, and M. D. Bronstein Human Macroprolactin Displays Low Biological Activity via Its Homologous Receptor in a New Sensitive Bioassay J. Clin. Endocrinol. Metab., March 1, 2006; 91(3): 1048 - 1055. [Abstract] [Full Text] [PDF]

				J. Gibney, T. P. Smith, and T. J. McKenna The Impact on Clinical Practice of Routine Screening for Macroprolactin J. Clin. Endocrinol. Metab., July 1, 2005; 90(7): 3927 - 3932. [Abstract] [Full Text] [PDF]

				N. Hattori, K. Ikekubo, Y. Nakaya, K. Kitagawa, and C. Inagaki Immunoglobulin G Subclasses and Prolactin (PRL) Isoforms in Macroprolactinemia Due to Anti-PRL Autoantibodies J. Clin. Endocrinol. Metab., May 1, 2005; 90(5): 3036 - 3044. [Abstract] [Full Text] [PDF]

				T. C. Friedman, W. T. Couldwell, M. H. Weiss, E. R. Laws Jr., G. L. Hortin, A. Colao, G. Lombardi, and J. Schlechte Prolactinomas N. Engl. J. Med., March 4, 2004; 350(10): 1054 - 1057. [Full Text] [PDF]

				O. Serri, C. L. Chik, E. Ur, and S. Ezzat Diagnosis and management of hyperprolactinemia Can. Med. Assoc. J., September 16, 2003; 169(6): 575 - 581. [Abstract] [Full Text]

				M. Fahie-Wilson In Hyperprolactinemia, Testing for Macroprolactin Is Essential Clin. Chem., September 1, 2003; 49(9): 1434 - 1436. [Full Text] [PDF]

				A. M. Suliman, T. P. Smith, J. Gibney, and T. J. McKenna Frequent Misdiagnosis and Mismanagement of Hyperprolactinemic Patients before the Introduction of Macroprolactin Screening: Application of a New Strict Laboratory Definition of Macroprolactinemia Clin. Chem., September 1, 2003; 49(9): 1504 - 1509. [Abstract] [Full Text] [PDF]

				C. Mounier, J. Trouillas, B. Claustrat, R. Duthel, and B. Estour Macroprolactinaemia associated with prolactin adenoma Hum. Reprod., April 1, 2003; 18(4): 853 - 857. [Abstract] [Full Text] [PDF]

				J. A. Schlechte The Macroprolactin Problem J. Clin. Endocrinol. Metab., December 1, 2002; 87(12): 5408 - 5409. [Full Text] [PDF]

				A. O. Olukoga Macroprolactinemia Is Clinically Important J. Clin. Endocrinol. Metab., October 1, 2002; 87(10): 4833 - 4834. [Full Text] [PDF]