Macroprolactin over time: Is there any point in rechecking it in people with a persistently elevated serum prolactin?

Autor: Livingston M; Department of Clinical Biochemistry, Black Country Pathology Services , Walsall Manor Hospital, Walsall, UK.; Faculty of Science and Engineering, School of Medicine and Clinical Practice, The University of Wolverhampton, Wolverhampton, UK., Hashmi SF; Department of Clinical Biochemistry, Black Country Pathology Services , Walsall Manor Hospital, Walsall, UK., Ramachandran S; Department of Clinical Biochemistry, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK.; Department of Clinical Biochemistry, University Hospitals of North Midlands, Stoke-on-Trent, UK.; Institute of Science and Technology, Keele University, Keele, UK.; Faculty of Health Sciences, Staffordshire University, Stoke-on-Trent, UK.; Department of Mechanical and Aerospace Engineering, Brunel University, London, UK., Laing I; Department of Clinical Biochemistry, Royal Preston Hospital, Preston, UK., Heald A; Department of Endocrinology and Diabetes, Salford Royal Hospital, Salford, UK.; The School of Medicine and Manchester Academic Health Sciences Centre, Manchester University, Manchester, UK.
Jazyk: angličtina
Zdroj: Clinical endocrinology [Clin Endocrinol (Oxf)] 2024 May; Vol. 100 (5), pp. 450-458. Date of Electronic Publication: 2024 Mar 27.
DOI: 10.1111/cen.15051
Abstrakt: Objective and Design: Macroprolactinemia may influence the interpretation of serum prolactin levels-a recognised phenomenon since 1981. The degree of macroprolactinaemia over time is less well described. We determined how macroprolactin status (based on polyethylene glycol (PEG) precipitation) varied by analysing serial measurements in hyperprolactinaemic individuals over a period of 9 years.
Patients and Measurements: Results from 1810 individuals were included. All serum total prolactin results (measured using Roche Cobas 8000 analyser) were extracted from the laboratory information system for the period 1 January 2012 to 1 April 2021, along with relevant patient demographic/test data. Samples with a macroprolactin screening test performed (on samples with prolactin > 700 miu/L) were included in the main analysis.
Results: During the study period, 2782 macroprolactin checks were performed (12.5% of all prolactin tests) in 1810 individuals (599 males/2183 females, median-age: 35, interquartile range: 25-47, range: 16-93 years). Multiple macroprolactin checks were carried out on 465 patients (1437 measurements) with 94 patients (141 measurements) screening positive (<60% recovery). Only 19 patients (18 female) had at least one result above and one below the 60% screening cut-off, with 10 of these patients having results close to the 60% cut-off; in 9 patients, results were clearly different between repeat samples. In seven cases, the adjusted monomeric prolactin showed a potentially clinically significant difference.
Conclusions: In this study, only 19/465 patients appeared to change macroprolactin status based on a 60% PEG recovery cut-off. The majority of these 19 patients were on antipsychotic/antidepressant medication(s) or had a prolactinoma; in only 7 did monomeric prolactin change significantly. This suggests that once macroprolactin status has been determined, clinical decision making is rarely affected by repeating it.
(© 2024 The Authors. Clinical Endocrinology published by John Wiley & Sons Ltd.)
Databáze: MEDLINE
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