title: Macroprolactinemia revisited: a study on 106 patients.
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 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.
authors.affiliation: Department of Endocrinology, Centre Hospitalier Universitaire Timone, 13385 Marseille Cedex 5.
authors.forename: Sophie
authors.initials: S
authors.lastname: Vallette-Kasic
authors.forename: Isabelle
authors.initials: I
authors.lastname: Morange-Ramos
authors.forename: Adel
authors.initials: A
authors.lastname: Selim
authors.forename: Ginette
authors.initials: G
authors.lastname: Gunz
authors.forename: Sophie
authors.initials: S
authors.lastname: Morange
authors.forename: Alain
authors.initials: A
authors.lastname: Enjalbert
authors.forename: Pierre-Marie
authors.initials: PM
authors.lastname: Martin
authors.forename: Philippe
authors.initials: P
authors.lastname: Jaquet
authors.forename: Thierry
authors.initials: T
authors.lastname: Brue
mesh_terms: 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
chemical_list: D013973:Thyrotropin-Releasing Hormone; D011388:Prolactin