Macroprolactin; a frequent cause of misdiagnosed hyperprolactinemia in clinical practice.
BACKGROUND
Macroprolactin is a significant cause of misdiagnosis, unnecessary investigation, and inappropriate treatment in patients with hyperprolactinemia. Its frequency has not been clearly established due to technical difficulties in identifying it. Most laboratories and clinicians are unaware of macroprolactin interferences in prolactin assays.


METHODS
A comprehensive literature search was conducted on the websites of the National Library of Medicine (http://www.ncbl.nlm.nih.gov) and PubMed Central, the US National Library of Medicine's digital archive of life sciences literature (http://www.pubmedcentral.nih.gov/). The data were also looked for in relevant books and journal.


RESULTS
Macroprolactin is a non-bioactive prolactin isoform usually composed of a prolactin monomer and an IgG molecule having a prolonged clearance rate similar to that of immunoglobulins. This isoform is clinically non-reactive but it interferes with immunological assays used for the detection of prolactin.


CONCLUSIONS
There is a need to understand and explore the recent progress in the diagnosis and pathophysiology of macroprolactinemia for improving patient care.
Guru Nanak Eye Center, New Delhi, India.
Vaishya
V
Richa
Gupta
G
Rahul
Arora
A
Sarika
Hyperprolactinemia; Macroprolactin; Polyethylene glycol assay; Prolactin; Prolactin antibody