Skip to main content
Top
Published in: Endocrine 2/2019

01-02-2019 | Original Article

Prevalence and reproductive manifestations of macroprolactinemia

Authors: Amanpreet Kaur Kalsi, Ashutosh Halder, Manish Jain, P. K. Chaturvedi, J. B. Sharma

Published in: Endocrine | Issue 2/2019

Login to get access

Abstract

Purpose

Macroprolactinemia is characterized by predominance of macroprolactin molecules in circulation and generally has extra-pituitary origin. Macroprolactin is viewed as biologically inactive, therefore asymptomatic, and thus may not require any treatment or prolonged follow-up. In addition, data on prevalence of macroprolactinemia and its clinical manifestation are also rare. Therefore, the present study was aimed to find out prevalence of macroprolactinemia and its association, if any, with reproductive manifestations.

Material and methods

Macroprolactin was measured in 102 hyperprolactinemia cases (>100 ng/ml prolactin level), 135 physiological hyperprolactinemia cases (50 pregnant and 85 lactating females; >100 ng/ml prolactin level) and 24 controls. Poly ethylene glycol (PEG) precipitation method was carried out to screen macroprolactin. Prolactin recovery of <25% was considered overt macroprolactinemia. Detailed clinical data was recorded which included complete medical history, physical examination and hormone measurements besides CT/MRI for pituitary abnormalities.

Results

Prevalence of macroprolactinemia was 21.57% (22/102) in hyperprolactinemia (prolactin >100 ng/ml). There was no case of macroprolactinemia in physiological hyperprolactinemia, or healthy control females. Reproductive manifestations were present in 72.73% (16/22) macroprolactinemia cases, out of which macroprolactinemia was the sole cause of associated reproductive manifestations in 68.7% (11/16) cases. Reversal of reproductive dysfunction/s was observed in five cases with appropriate treatment for high macroprolactin.

Conclusion

Macroprolactinemia prevalence was found to be 21.5%, out of which 72.73% cases had associated reproductive dysfunctions.
Literature
2.
go back to reference J.G.H. Vieira, Macroprolactinemia. Arq. Bras. Endocrinol. Metab. 46, 45–50 (2002)CrossRef J.G.H. Vieira, Macroprolactinemia. Arq. Bras. Endocrinol. Metab. 46, 45–50 (2002)CrossRef
3.
go back to reference T.S. Morteza, A.E. Hossein, K.D. M, Evaluating the prevalence of macroprolactinemia and hyperprolactinemia and comparing their clinical and radiological signs in infertile women. J. Reprod. Infertil. 8, 128–134 (2007) T.S. Morteza, A.E. Hossein, K.D. M, Evaluating the prevalence of macroprolactinemia and hyperprolactinemia and comparing their clinical and radiological signs in infertile women. J. Reprod. Infertil. 8, 128–134 (2007)
5.
go back to reference K.M. Genesio Ceratto, M.M. Zitta, P. Avalos, M.H. Gomez, C. Avendano, C. Sanchez Sarmiento, Prevalence of macroprolactin (mprl) in infertile female patients: frequent misdiagnosis and mismanagement of hyperprolactinemia. Fertil. Steril. 106, 373 (2016)CrossRef K.M. Genesio Ceratto, M.M. Zitta, P. Avalos, M.H. Gomez, C. Avendano, C. Sanchez Sarmiento, Prevalence of macroprolactin (mprl) in infertile female patients: frequent misdiagnosis and mismanagement of hyperprolactinemia. Fertil. Steril. 106, 373 (2016)CrossRef
7.
go back to reference L. Vilar, E. Moura, V. Canadas, A. Gusmão, R. Campos, E. Leal, L. Teixeira, V. Santos, B. Gomes, M. Lima, R. Paiva, J.L. Albuquerque, C.S. Egito, C.A. Botelho, M. Azevedo, L.A. Casulari, L.A. Naves, Prevalence of macroprolactinemia among 115 patients with hyperprolactinemia]. Arq. Bras. Endocrinol. Metabol. 51, 86–91 (2007)CrossRefPubMed L. Vilar, E. Moura, V. Canadas, A. Gusmão, R. Campos, E. Leal, L. Teixeira, V. Santos, B. Gomes, M. Lima, R. Paiva, J.L. Albuquerque, C.S. Egito, C.A. Botelho, M. Azevedo, L.A. Casulari, L.A. Naves, Prevalence of macroprolactinemia among 115 patients with hyperprolactinemia]. Arq. Bras. Endocrinol. Metabol. 51, 86–91 (2007)CrossRefPubMed
9.
go back to reference T. Bjøro, E. Johansen, H.H. Frey, A. Turter, P.A. Torjesen, Different responses in little and bigbig prolactin to metoclopramide in subjects with hyperprolactinemia due to 150-170 kD (bigbig) prolactin. Acta Endocrinol. 128, 308–312 (1993)CrossRefPubMed T. Bjøro, E. Johansen, H.H. Frey, A. Turter, P.A. Torjesen, Different responses in little and bigbig prolactin to metoclopramide in subjects with hyperprolactinemia due to 150-170 kD (bigbig) prolactin. Acta Endocrinol. 128, 308–312 (1993)CrossRefPubMed
11.
go back to reference A.N. Andersen, H. Pedersen, H. Djursing, B.N. Andersen, H.G. Friesen, Bioactivity of prolactin in a woman with an excess of large molecular size prolactin, persistent hyperprolactinemia and spontaneous conception. Fertil. Steril. 38, 625–628 (1982)CrossRefPubMed A.N. Andersen, H. Pedersen, H. Djursing, B.N. Andersen, H.G. Friesen, Bioactivity of prolactin in a woman with an excess of large molecular size prolactin, persistent hyperprolactinemia and spontaneous conception. Fertil. Steril. 38, 625–628 (1982)CrossRefPubMed
15.
go back to reference I.R. Wallace, N. Satti, C.H. Courtney, H. Leslie, P.M. Bell, S.J. Hunter, D.R. McCance, B. Sheridan, A.B. Atkinson, Ten-year clinical follow-up of a cohort of 51 patients with macroprolactinemia establishes it as a benign variant. J. Clin. Endocrinol. Metab. 95, 3268–3271 (2010). https://doi.org/10.1210/jc.2010-0114 CrossRefPubMed I.R. Wallace, N. Satti, C.H. Courtney, H. Leslie, P.M. Bell, S.J. Hunter, D.R. McCance, B. Sheridan, A.B. Atkinson, Ten-year clinical follow-up of a cohort of 51 patients with macroprolactinemia establishes it as a benign variant. J. Clin. Endocrinol. Metab. 95, 3268–3271 (2010). https://​doi.​org/​10.​1210/​jc.​2010-0114 CrossRefPubMed
19.
go back to reference O.M. Hauache, A.J. Rocha, A.C.M. Maia, R.M.B. Maciel, J.G.H. Vieira, Screening for macroprolactinaemia and pituitary imaging studies. Clin. Endocrinol. 57, 327–331 (2002)CrossRef O.M. Hauache, A.J. Rocha, A.C.M. Maia, R.M.B. Maciel, J.G.H. Vieira, Screening for macroprolactinaemia and pituitary imaging studies. Clin. Endocrinol. 57, 327–331 (2002)CrossRef
20.
go back to reference M. Overgaard, S.M. Pedersen, Serum prolactin revisited: parametric reference intervals and cross platform evaluation of polyethylene glycol precipitation-based methods for discrimination between hyperprolactinemia and macroprolactinemia. Clin. Chem. Lab. Med. 55, 1744–1753 (2017). https://doi.org/10.1515/cclm-2016-0902 CrossRefPubMed M. Overgaard, S.M. Pedersen, Serum prolactin revisited: parametric reference intervals and cross platform evaluation of polyethylene glycol precipitation-based methods for discrimination between hyperprolactinemia and macroprolactinemia. Clin. Chem. Lab. Med. 55, 1744–1753 (2017). https://​doi.​org/​10.​1515/​cclm-2016-0902 CrossRefPubMed
21.
go back to reference M.W.J. Strachan, W.L. Teoh, A.C. Don-Wauchope, J. Seth, M. Stoddart, G.J. Beckett, Clinical and radiological features of patients with macroprolactinaemia. Clin. Endocrinol. 59, 339–346 (2003)CrossRef M.W.J. Strachan, W.L. Teoh, A.C. Don-Wauchope, J. Seth, M. Stoddart, G.J. Beckett, Clinical and radiological features of patients with macroprolactinaemia. Clin. Endocrinol. 59, 339–346 (2003)CrossRef
26.
go back to reference N. Hattori, K. Ikekubo, T. Ishihara, K. Moridera, M. Hino, H. Kurahachi, Correlation of the antibody titers with serum prolactin levels and their clinical course in patients with anti-prolactin autoantibody. Eur. J. Endocrinol. 130, 438–445 (1994)CrossRefPubMed N. Hattori, K. Ikekubo, T. Ishihara, K. Moridera, M. Hino, H. Kurahachi, Correlation of the antibody titers with serum prolactin levels and their clinical course in patients with anti-prolactin autoantibody. Eur. J. Endocrinol. 130, 438–445 (1994)CrossRefPubMed
31.
go back to reference S. Radavelli-Bagatini, F.L. Lhullier, E.S. Mallmann, P.M. Spritzer, Macroprolactinemia in women with hyperprolactinemia: a 10-year follow-up. Neuro. Endocrinol. Lett. 34, 207–211 (2013)PubMed S. Radavelli-Bagatini, F.L. Lhullier, E.S. Mallmann, P.M. Spritzer, Macroprolactinemia in women with hyperprolactinemia: a 10-year follow-up. Neuro. Endocrinol. Lett. 34, 207–211 (2013)PubMed
37.
go back to reference J.G. Vieira, T.T. Tachibana, L.H. Obara, R.M. Maciel, Extensive experience and validation of polyethylene glycol precipitation as a screening method for macroprolactinemia. Clin. Chem. 44, 1758–1759 (1998)PubMed J.G. Vieira, T.T. Tachibana, L.H. Obara, R.M. Maciel, Extensive experience and validation of polyethylene glycol precipitation as a screening method for macroprolactinemia. Clin. Chem. 44, 1758–1759 (1998)PubMed
39.
go back to reference A.M. Suliman, T.P. Smith, J. Gibney, 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. 49, 1504–1509 (2003)CrossRefPubMed A.M. Suliman, T.P. Smith, J. Gibney, 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. 49, 1504–1509 (2003)CrossRefPubMed
40.
Metadata
Title
Prevalence and reproductive manifestations of macroprolactinemia
Authors
Amanpreet Kaur Kalsi
Ashutosh Halder
Manish Jain
P. K. Chaturvedi
J. B. Sharma
Publication date
01-02-2019
Publisher
Springer US
Published in
Endocrine / Issue 2/2019
Print ISSN: 1355-008X
Electronic ISSN: 1559-0100
DOI
https://doi.org/10.1007/s12020-018-1770-6

Other articles of this Issue 2/2019

Endocrine 2/2019 Go to the issue
Live Webinar | 27-06-2024 | 18:00 (CEST)

Keynote webinar | Spotlight on medication adherence

Live: Thursday 27th June 2024, 18:00-19:30 (CEST)

WHO estimates that half of all patients worldwide are non-adherent to their prescribed medication. The consequences of poor adherence can be catastrophic, on both the individual and population level.

Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.

Prof. Kevin Dolgin
Prof. Florian Limbourg
Prof. Anoop Chauhan
Developed by: Springer Medicine
Obesity Clinical Trial Summary

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine

Highlights from the ACC 2024 Congress

Year in Review: Pediatric cardiology

Watch Dr. Anne Marie Valente present the last year's highlights in pediatric and congenital heart disease in the official ACC.24 Year in Review session.

Year in Review: Pulmonary vascular disease

The last year's highlights in pulmonary vascular disease are presented by Dr. Jane Leopold in this official video from ACC.24.

Year in Review: Valvular heart disease

Watch Prof. William Zoghbi present the last year's highlights in valvular heart disease from the official ACC.24 Year in Review session.

Year in Review: Heart failure and cardiomyopathies

Watch this official video from ACC.24. Dr. Biykem Bozkurt discusses last year's major advances in heart failure and cardiomyopathies.