[Macroprolactin as etiology of hyperprolactinemia. Method for detection and clinical characterization of the entity in 39 patients].
The presence of serum macroprolactin is a relatively frequent situation that can lead to expensive explorations and ineffective treatments. The precipitation with polyethylene glycols permits its detection rapidly, trustworthily, and inexpensively. The objective of the present work has been to assess the incidence of macroprolactin in patients with hyperprolactinemia through its identification with polyethylene glycols, as well as the clinical and radiological findings, and the response in these patients to the treatment. For it the clinical history of all the cases in which there was detected macroprolactinemia, some of them with several years of previous follow-up, was reviewed exhaustively. Of the 1505 patients in which prolactin level was determined, 195 (13%) showed values higher than 40 microg/l. In 39 (20%) of them the presence of macroprolactin was detected. After observing the evolution of these patients, spontaneously or under treatment with dopaminergic agonists, a clear relationship of causality between the presence of macroprolactin and the clinical manifestations was not found, except in a case of galactorrhea. In 27 cases nuclear magnetic resonance was done; in 4 of them a picture was observed compatible with small microadenoma or microcyst and in no patient a macroadenoma was detected. We conclude that the macroprolactinemia is a relatively frequent and easily detected entity through precipitation with polyethylene glycols. It has a limited relation with the clinical findings and there should always be sought other possible causes of this situation. It is an apparently benign situation and its identification can avoid unnecessary explorations and treatments.
García Menéndez
L
L
Servicio de Análisis Clínicos, Hospital del Bierzo, León. lgarcia@hbrz.sacyl.es
Díez Hernández
A
A
Ciriza de los Ríos
C
C
Delgado Gómez
M
M
Orejas García
A
A
Fernández Erales
A L
AL
González Mateo
C
C
Fernández Fernández
M
M
D000293:Adolescent; D000328:Adult; D002648:Child; D005260:Female; D006801:Humans; D006966:Hyperprolactinemia / Q000097:blood / Q000175:diagnosis*; D008297:Male; D008875:Middle Aged; D011092:Polyethylene Glycols; D011388:Prolactin / Q000097:blood*; D012016:Reference Values
C060678:prolactin, polymeric; D011092:Polyethylene Glycols; D011388:Prolactin