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Year: 2012, Volume: 22, Issue: 1

Macroprolactinemia: new insights in hyperprolactinemia

Content Provider	PubMed Central
Author	Kasum, Miro Oreskovic, Slavko Zec, Ivana Jezek, Davor Tomic, Vlatka Gall, Vesna Adzic, Goran
Copyright Year	2012
Abstract	Hypersecretion of prolactin by lactotroph cells of the anterior pituitary may lead to hyperprolactinemia in physiological, pathological and idiopathic conditions. Most patients with idiopathic hyperprolactinemia may have radiologically undetected microprolactinomas, but some may present other causes of hyperprolactinemia described as macroprolactinemia. This condition corresponds to the predominance of higher molecular mass prolactin forms (big-big prolactin, MW > 150 kDa), that have been postulated to represent prolactin monomer complexed with anti-prolactin immunoglobulins or autoantibodies. The prevalence of macroprolactinemia in hyperprolactinemic populations between 15–46% has been reported. In the pathophysiology of macroprolactinemia it seems that pituitary prolactin has antigenicity, leading to the production of anti-prolactin autoantibodies, and these antibodies reduce prolactin bioactivity and delay prolactin clearance. Antibody-bound prolactin is big enough to be confined to vascular spaces, and therefore macroprolactinemia develops due to the delayed clearance of prolactin rather than increased production. Although the clinical symptoms are less frequent in macroprolactinemic patients, they could not be diff erentiated from true hyperprolactinemic patients, on the basis of clinical features alone. Although gel filtration chromatography (GFC) is known to be the gold standard for detecting macroprolactin, the polyethylene glycol precipitation (PEG) method has off ered a simple, cheap, and highly suitable alternative. In conclusion, macroprolactinemia can be considered a benign condition with low incidence of clinical symptoms and therefore hormonal and imaging investigations as well as medical or surgical treatment and prolonged follow-up are not necessary.
Ending Page	179
Starting Page	171
File Format	PDF
ISSN	18467482
e-ISSN	18467482
Journal	Biochemia Medica
Issue Number	2
Volume Number	22
Language	English
Publisher	Croatian Society of Medical Biochemistry and Laboratory Medicine
Publisher Date	2012-06-15
Access Restriction	Open
Rights Holder	Croatian Society of Medical Biochemistry and Laboratory Medicine
Subject Keyword	Research in Higher Education
Content Type	Text
Resource Type	Article

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