“Incidentalormones” - Macro-hormones

Abstract

Introduction: Complexes of monomeric hormone molecules immunoglobulin-associated lead to the formation of macro-complexes biologically inactive that are called macro-hormones. Patients’ presenting unexpectedly elevated hormones values indicates the need that the existence of macro-hormones must be researched.
 Objective: To describe the macro-hormones discovered incidentally in laboratory tests, which we refer to as "incidentalormones".
 Methods: An integrative review was conducted, and data was gathered from the published articles in medical database. The different forms of macro-hormones are reviewed; the biochemical significance and laboratory assays of macro-hormones are also revised within the ambit of current laboratory medicine. We discussed diagnostic difficulty encountered in patients with "incidentalormones”, as well as methods of macro-hormone detection, immunoglobulin involved, clinical significance and associations with other diseases.
 Conclusion: The presence of macro-hormones, often guides us to intervention in laboratory trials, and could result in false-positive diagnosis with inadequate therapy. Laboratories should follow a diagnostic algorithm to carefully recognize and examine possible immunoassay interferences.

Pars Distalis and Pars Tuberalis Thyroid-Stimulating Hormones and Their Roles in Macro-Thyroid-Stimulating Hormone Formation

“…Macro-FSH and macro-LH are generated by the binding of auto-antibodies against no defined epitopes. In the case of macro-PRL the protein region involved in binding to the PRL receptor is suspected to be the main epitope [46,47]. Macro-ACTH results from the incomplete cleavage of pro-opiomelancortin, the prohormone for the generation of ACTH, β-lipoprotein, β-endorphin and α-melanocyte-stimulating hormone (MSH).…”