title: Macroprolactinemia in childhood and adolescence: a cause of hyperprolactinemia.
abstract: Human prolactin consists of multiple forms of different sizes including three major prolactin (PRL) species, termed as little, big, and big-big PRL. If serum contains big-big PRL, it is termed macroprolactinemia; no symptoms of hyperprolactinemia develop due to low biological activity of big-big PRL. There are still few data regarding macroprolactinemia in children and adolescents. In this paper we describe six patients with macroprolactinemia, one of whom was asymptomatic and the other five either had headache, menstrual disturbance, short stature, increased hair growth or early puberty, compatible with high PRL levels. Two of the cases had microadenoma. Initial mean +/- SD PRL levels of the patients were 75.2 +/- 22.8 ng/ml (range: 42.3-105.2 ng/ml). Macroprolactin analysis revealed big-big PRL levels of the patients ranging between 21.6-98.6 ng/ml. It was noteworthy that bromocriptine (BRC) therapy started in three patients caused an abrupt decrease in PRL levels. It may be concluded that macroprolactinemia should be taken into account in the differential diagnosis of hyperprolactinemia in childhood and adolescence, whether or not they have relevant clinical symptoms.
authors.affiliation: Pediatric Endocrinology Unit, Department of Pediatrics, Istanbul University Faculty of Medicine, Turkey.
authors.forename: Filiz
authors.initials: F
authors.lastname: Tütüncüler
authors.forename: Feyza
authors.initials: F
authors.lastname: Darendeliler
authors.forename: Menekşe
authors.initials: M
authors.lastname: Aygün
authors.forename: Nezih
authors.initials: N
authors.lastname: Hekim
mesh_terms: D000236:Adenoma / Q000150:complications; D000293:Adolescent; D002648:Child; D004392:Dwarfism / Q000209:etiology; D005260:Female; D006261:Headache / Q000209:etiology; D006628:Hirsutism / Q000209:etiology; D006801:Humans; D006966:Hyperprolactinemia / Q000097:blood / Q000150:complications / Q000175:diagnosis* / Q000209:etiology; D008279:Magnetic Resonance Imaging; D008297:Male; D008599:Menstruation Disturbances / Q000209:etiology; D010911:Pituitary Neoplasms / Q000150:complications; D011092:Polyethylene Glycols; D011388:Prolactin / Q000737:chemistry; D011629:Puberty, Precocious / Q000209:etiology
chemical_list: C060678:prolactin, polymeric; D011092:Polyethylene Glycols; D011388:Prolactin