Macroprolactinemia revisited: a study on 106 patients.
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 microg/liter (range, 20-663) and exceeded 100 microg/liter in 8.5% of patients; 4) PRL levels usually remained stable over time; 5) on dopaminergic therapy, PRL returned to normal in 21 of 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.
Vallette-Kasic
Sophie
S
Department of Endocrinology, Centre Hospitalier Universitaire Timone, 13385 Marseille Cedex 5.
Morange-Ramos
Isabelle
I
Selim
Adel
A
Gunz
Ginette
G
Morange
Sophie
S
Enjalbert
Alain
A
Martin
Pierre-Marie
PM
Jaquet
Philippe
P
Brue
Thierry
T
D000236:Adenoma / Q000150:complications / Q000175:diagnosis; D000328:Adult; D015551:Autoimmunity; D002845:Chromatography; D003560:Cysts / Q000150:complications / Q000175:diagnosis; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006966:Hyperprolactinemia / Q000097:blood / Q000209:etiology / Q000276:immunology / Q000503:physiopathology*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D008970:Molecular Weight; D010900:Pituitary Diseases / Q000150:complications / Q000175:diagnosis; D010902:Pituitary Gland / Q000473:pathology; D010911:Pituitary Neoplasms / Q000150:complications / Q000175:diagnosis; D011247:Pregnancy; D011248:Pregnancy Complications / Q000503:physiopathology; D011388:Prolactin / Q000097:blood* / Q000737:chemistry*; D011446:Prospective Studies; D012016:Reference Values; D013973:Thyrotropin-Releasing Hormone / Q000494:pharmacology
D013973:Thyrotropin-Releasing Hormone; D011388:Prolactin