Importance of macroprolactinemia in hyperprolactinemia

Kasum, Miro; Pavičić-Baldani, Dinka; Stanić, Patrik; Orešković, Slavko; Šarić, Jakov-Marko; Blajić, Jozo; Juras, Josip

doi:10.1016/j.ejogrb.2014.10.013

Cited by 33 publications

(28 citation statements)

References 36 publications

(81 reference statements)

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“…Hiperprolaktinemi kızlarda amenore, galaktore, hirsutizm, baş ağrısı, çift görme, büyüme geriliği ve polikistik over sendromu semptomlarına neden olan sık görülen bir klinik durumdur (1) . Prolaktin molekülleri dolaşımda monomerik, dimerik ve makroprolaktin şeklinde çeşitli moleküler ağırlıkta heterojen şekilde dolaşmaktadır (2,3) . Monomerik prolaktin 23 kilodalton, dimerik prolaktin 45-60 kilodalton, makroprolaktin 150-170 kilodalton molekül ağırlığındadır (2,3) .…”

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“…Prolaktin molekülleri dolaşımda monomerik, dimerik ve makroprolaktin şeklinde çeşitli moleküler ağırlıkta heterojen şekilde dolaşmaktadır (2,3) . Monomerik prolaktin 23 kilodalton, dimerik prolaktin 45-60 kilodalton, makroprolaktin 150-170 kilodalton molekül ağırlığındadır (2,3) . Kanda ölçülen prolaktin miktarının %30-60'dan fazlası makroprolaktinemiden oluşuyorsa makroprolaktinemi düşünülmelidir (2,3) .…”

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“…Monomerik prolaktin 23 kilodalton, dimerik prolaktin 45-60 kilodalton, makroprolaktin 150-170 kilodalton molekül ağırlığındadır (2,3) . Kanda ölçülen prolaktin miktarının %30-60'dan fazlası makroprolaktinemiden oluşuyorsa makroprolaktinemi düşünülmelidir (2,3) . Makroprolaktin olan olgular klinik semptom olmadan yüksek prolaktin seviyesi ile prezente olmaktadır.…”

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“…Bu çalışmada, yüksek kan prolaktin nedeniyle ailede endişe yaratan bir makroprolaktinemi olgusu sunulmuştur. Prolaktin yüksekliği ile başvuran olgularda, prolaktin yüksekliğinin klinik bulguları yoksa strese bağlı prolaktin yüksekliği, ilaç kullanımı, laboratuvar hatası ve makroprolaktinemi düşünülmelidir (1)(2)(3) . Kan prolaktin yüksekliğine klinik bulgular eşlik ediyorsa santral patolojiler açısından hipofiz ve hipotalamus görüntülemesi yapılmalıdır.…”

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“…Ayrıca, hiperprolaktinemi nedenleri arasında hipotiroidizm, böbrek ve karaciğer yetmezliği, interkostal sinir stimulasyonu ve polikistik over sendromu bulunur. Makroprolaktinemi dolaşımdaki prolaktin molekülünün IgG ve IgM yapısındaki antikorlarla birleşmesinden oluşur (2)(3)(4) . Makroprolaktin olan olgularda prolaktin hormonu biyoinaktiftir ve hedef organlarda reseptöre bağlama kapasitesi düşüktür (2)(3)(4) .…”

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Are All High Blood Prolactin Levels Pathological?

Korkmaz¹

2018

BUCH

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Are All High Blood Prolactin Levels Pathological?

Korkmaz¹

2018

BUCH

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Evaluation of autoantibodies and immunoglobulin G subclasses in women with suspected macroprolactinemia

Fan

et al. 2020

Clinical Laboratory Analysis

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Levodopa‐refractory hyperprolactinemia and pituitary findings in inherited disorders of biogenic amine metabolism

Yıldız

Hübschmann

Karaosmanoglu

et al. 2023

J of Inher Metab Disea

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Elevated serum prolactin concentrations occur in inherited disorders of biogenic amine metabolism because dopamine deficiency leads to insufficient inhibition of prolactin secretion. This work from the International Working Group on Neurotransmitter Related Disorders (iNTD) presents the results of the first standardized study on levodopa‐refractory hyperprolactinemia (LRHP; >1000 mU/L) and pituitary magnetic resonance imaging (MRI) abnormalities in patients with inherited disorders of biogenic amine metabolism. Twenty‐six individuals had LRHP or abnormal pituitary findings on MRI. Tetrahydrobiopterin deficiencies were the most common diagnoses (n = 22). The median age at diagnosis of LRHP was 16 years (range: 2.5–30, 1st–3rd quartiles: 12.25–17 years). Twelve individuals (nine females) had symptoms attributed to hyperprolactinemia: menstruation‐related abnormalities (n = 7), pubertal delay or arrest (n = 5), galactorrhea (n = 3), and decreased sexual functions (n = 2). MRI of the pituitary gland was obtained in 21 individuals; six had heterogeneity/hyperplasia of the gland, five had adenoma, and 10 had normal findings. Eleven individuals were treated with the dopamine agonist cabergoline, ameliorating the hyperprolactinemia‐related symptoms in all those assessed. Routine monitoring of these symptoms together with prolactin concentrations, especially after the first decade of life, should be taken into consideration during follow‐up evaluations. The potential of slow‐release levodopa formulations and low‐dose dopamine agonists as part of first‐line therapy in the prevention and treatment of hyperprolactinemia should be investigated further in animal studies and human trials. This work adds hyperprolactinemia‐related findings to the current knowledge of the phenotypic spectrum of inherited disorders of biogenic amine metabolism.

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Importance of macroprolactinemia in hyperprolactinemia

Cited by 33 publications

References 36 publications

Are All High Blood Prolactin Levels Pathological?

Are All High Blood Prolactin Levels Pathological?

Evaluation of autoantibodies and immunoglobulin G subclasses in women with suspected macroprolactinemia

Levodopa‐refractory hyperprolactinemia and pituitary findings in inherited disorders of biogenic amine metabolism

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