Evaluation of macroprolactinemia in 259 women under investigation for polycystic ovary syndrome

Hayashida, Sylvia Asaka Yamashita; Marcondes, José Antônio Miguel; Soares, José Maria; Rocha, Marco; Barcellos, Cristiano Roberto Grimaldi; Kobayashi, Nelly K. A.; Baracat, Edmund C.; Maciel, Gustavo Arantes Rosa

doi:10.1111/cen.12266

Cited by 17 publications

(14 citation statements)

References 7 publications

(14 reference statements)

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“…The recent study of Hayashida& al. demonstrates that the elevation of prolactin linked to the presence of a macroprolactin is not uncommon in PCOS women and that it is therefore essential to screen it 74 . This first step is essential to limit the misdiagnosis and thus avoid the unnecessary prescription of a pituitary MRI or even dopaminergic agonist treatment, as already pointed out by Escobar-Morreale years ago 98 .…”

Section: Resultsmentioning

confidence: 99%

“…Hayashida et al in 2014 studied a larger population of 227 PCOS women. 6% of PCOS women had elevated prolactin (n = 16), which was consistently explained by the presence of macroprolactin 74 .…”

Section: Prevalence and Causes Of Hprl In Pcos Womenmentioning

confidence: 93%

“…The majority of this studies was conducted before the first diagnostic criteria of PCOS published in 1990 by the NIH 59,60,[63][64][65][66][67][68][69][70][71][72] . When analyzing all of these studies according to their years of publication, we note that the prevalence of hyperprolactinemia is more homogeneous since the PCOS was diagnosed with consensus criteria [73][74][75][76][77] (Fig. 2).…”

Section: Prevalence and Causes Of Hprl In Pcos Womenmentioning

confidence: 99%

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PCOS and Hyperprolactinemia: what do we know in 2019?

Delcour

Robin

Young

et al. 2019

Clin Med�Insights�Reprod�Health

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Polycystic ovary syndrome (PCOS) and hyperprolactinemia (HPRL) are the two most common etiologies of anovulation in women. Since the 1950s, some authors think that there is a pathophysiological link between PCOS and HPRL. Since then, many authors have speculated about the link between these two endocrine entities, but no hypothesis proposed so far could ever be confirmed. Furthermore, PCOS and HPRL are frequent endocrine diseases and a fortuitous association cannot be excluded. The evolution of knowledge about PCOS and HPRL shows that studies conducted before the 2000s are obsolete given current knowledge. Indeed, most of the studies were conducted before consensual diagnosis criteria of PCOS and included small numbers of patients. In addition, the investigation of HPRL in these studies relied on obsolete methods and did not look for the presence of macroprolactinemia. It is therefore possible that HPRL that has been attributed to PCOS corresponded in fact to macroprolactinemia or to pituitary microadenomas of small sizes that could not be detected with the imaging methods of the time. Recent studies that have conducted a rigorous etiological investigation show that HPRL found in PCOS correspond either to non-permanent increase of prolactin levels, to macroprolactinemia or to other etiologies. None of this recent study found HPRL related to PCOS in these patients. Thus, the link between PCOS and HPRL seems to be more of a myth than a well-established medical reality and we believe that the discovery of an HPRL in a PCOS patient needs a standard etiological investigation of HPRL.

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Section: Resultsmentioning

confidence: 99%

Section: Prevalence and Causes Of Hprl In Pcos Womenmentioning

confidence: 93%

Section: Prevalence and Causes Of Hprl In Pcos Womenmentioning

confidence: 99%

See 1 more Smart Citation

PCOS and Hyperprolactinemia: what do we know in 2019?

Delcour

Robin

Young

et al. 2019

Clin Med�Insights�Reprod�Health

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“…10 Our patient had features of PCOS, and it has been shown that macroprolactinemia is found in 5.8% in women with PCOS. 11 However, the link between these 2 conditions is still unknown.…”

Section: Discussionmentioning

confidence: 99%

A Macroprolactin Level Today May Keep Health Care Cost and the Surgical Knife at Bay

Henry

Bowden

2014

Clin Pediatr (Phila)

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“…Overall, symptoms related to hyperprolactinemia (galactorrhea, menstrual disorders and sexual dysfunction) have been reported in up to 45% of patients with macroprolactinemia (56,58,69,70,73,74,76,83,84). As mentioned, this would mostly result from the concomitance with monomeric hyperprolactinemia (74,75,85) or other disorders, such as polycystic ovary syndrome (1,61,62). Of note, the finding of both galactorrhea and menstrual disorders is rare in macroprolactinemia (83,84).…”

Section: Macroprolactinemia Screening: Routinely or Just In Asymptomamentioning

confidence: 99%

Controversial issues in the management of hyperprolactinemia and prolactinomas – An overview by the Neuroendocrinology Department of the Brazilian Society of Endocrinology and Metabolism

Vilar¹,

Abucham²,

Albuquerque³

et al. 2018

Archives of Endocrinology and Metabolism

102

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Prolactinomas are the most common pituitary adenomas (approximately 40% of cases), and they represent an important cause of hypogonadism and infertility in both sexes. The magnitude of prolactin (PRL) elevation can be useful in determining the etiology of hyperprolactinemia. Indeed, PRL levels > 250 ng/mL are highly suggestive of the presence of a prolactinoma. In contrast, most patients with stalk dysfunction, drug-induced hyperprolactinemia or systemic diseases present with PRL levels < 100 ng/mL. However, exceptions to these rules are not rare. On the other hand, among patients with macroprolactinomas (MACs), artificially low PRL levels may result from the so-called "hook effect". Patients harboring cystic MACs may also present with a mild PRL elevation. The screening for macroprolactin is mostly indicated for asymptomatic patients and those with apparent idiopathic hyperprolactinemia. Dopamine agonists (DAs) are the treatment of choice for prolactinomas, particularly cabergoline, which is more effective and better tolerated than bromocriptine. After 2 years of successful treatment, DA withdrawal should be considered in all cases of microprolactinomas and in selected cases of MACs. In this publication, the goal of the Neuroendocrinology Department of the Brazilian Society of Endocrinology and Metabolism (SBEM) is to provide a review of the diagnosis and treatment of hyperprolactinemia and prolactinomas, emphasizing controversial issues regarding these topics. This review is based on data published in the literature and the authors' experience.

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Evaluation of macroprolactinemia in 259 women under investigation for polycystic ovary syndrome

Cited by 17 publications

References 7 publications

PCOS and Hyperprolactinemia: what do we know in 2019?

PCOS and Hyperprolactinemia: what do we know in 2019?

A Macroprolactin Level Today May Keep Health Care Cost and the Surgical Knife at Bay

Controversial issues in the management of hyperprolactinemia and prolactinomas – An overview by the Neuroendocrinology Department of the Brazilian Society of Endocrinology and Metabolism

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