Macroprolactinaemia: validation and application of the polyethylene glycol precipitation test and clinical characterization of the condition

Olukoga, A O; Kane, John

doi:10.1046/j.1365-2265.1999.00757.x

Cited by 147 publications

(156 citation statements)

References 27 publications

(40 reference statements)

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“…Given its high intrinsic performance (according to its ROC curve), PEG precipitation appeared to be a successful screening test for the diagnosis of MPRL. However, in our experience, the grey area of PRL recovery (30-80%), for which GFC was necessary for diagnosis, was more extensive than that described previously (19,20,21,29) and encompassed about half of the samples. On the basis of data shown in Fig.…”

Section: Discussionmentioning

confidence: 44%

“…In order to limit the number of GFC required, alternative separation methods have been developed. Amongst them, polyethylene glycol (PEG) precipitation of bbPRL is the most commonly employed (19,20,21,22). Analysis of the discrepancies between results obtained from two PRL assays, with different crossreactivities, has been suggested as a viable MPRL analysis technique (23,24).…”

Section: Introductionmentioning

confidence: 99%

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Macroprolactinaemia: a biological diagnostic strategy from the study of 222 patients

Parlant-Pinet

Harthé

Roucher

et al. 2015

European Journal of Endocrinology

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Objectives: Gel filtration chromatography (GFC), the gold standard for macroprolactinaemia (MPRL) diagnosis, is a slow, costly and labour-intensive method. To limit the number of GFC required, we evaluated two screening tests for MPRL: prolactin (PRL) recovery after polyethylene glycol (PEG) precipitation and PRL concentration ratio, derived from two assays, each having different big-big-PRL cross-reactivities. In some patients, MPRL is characterised by clinical symptoms which can be associated with an excess of monomeric PRL. We compared the monomeric PRL concentration obtained from GFC with the PRL concentration i) on a cobas e 601 analyser and ii) in the supernatant after PEG precipitation. Design and methods: We studied hyperprolactinaemic sera subjected to physician-ordered GFC, between February 2013 and July 2014. We performed PEG precipitation (to evaluate the PRL concentration and rate of recovery in the supernatant) and two PRL assays: RIA and electrochemiluminescent assay (ECLIA), on a Roche cobas e 601 analyser, and calculated the RIA/ECLIA ratio. Results: Among the 222 sera, we were able to diagnose or exclude MPRL in 72.1% of cases, based solely on the ratio and/or recovery. In the remaining cases, GFC was necessary for making a diagnosis. Elevated monomeric PRL was present in 10.9% of macroprolactinaemic sera. In the case of MPRL, both PRL measurements on the cobas analyser and in the supernatant weakly correlated with monomeric PRL values obtained from GFC. Conclusions: The combination of PEG and RIA/ECLIA ratio analysis reduced the number of necessary GFC. However, GFC is essential in MPRL cases to evaluate the monomeric PRL concentration.

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Section: Discussionmentioning

confidence: 44%

Section: Introductionmentioning

confidence: 99%

Macroprolactinaemia: a biological diagnostic strategy from the study of 222 patients

Parlant-Pinet

Harthé

Roucher

et al. 2015

European Journal of Endocrinology

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“…In normal subjects, the proportions of monomeric, big, and big-big PRL components were reportedly 85.8%±2.3%, 9.1%±0.9%, and 5.1%±1.7%, respectively, and big PRL was shown to be a PRL dimer [1]. Macroprolactinaemia is a condition in which big-big PRL is substantially increased in the serum, often causing hyperprolactinaemia [2][3][4][5][6][7][8][9]. The prevalence of macroprolactinaemia is reportedly 10%-26% in patients with hyperprolactinaemia [2-6] and 3.68% in healthy hospital workers [9].…”

Section: Introductionmentioning

confidence: 99%

A possible cause of the variable detectability of macroprolactin by different immunoassay systems

Hattori

Aisaka²,

Shimatsu

2016

Clinical Chemistry and Laboratory Medicine (CCLM)

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Background: Macroprolactinaemia is a major cause of hyperprolactinaemia. The detectability of macroprolactin varies widely among different immunoassay systems, but the causes are not fully known. This study aimed to identify the factors influencing the detectability of macroprolactin by immunoassay systems. Methods: The study included 1544 patients who visited an obstetric and gynaecological hospital. Macroprolactinaemia was screened using the polyethylene glycol (PEG) method and confirmed using gel filtration chromatography and the protein G method. The prolactin (PRL) values determined by enzyme immunoassay (EIA) were compared with those of a chemiluminescence immunoassay system (Centaur) that is known to cross-react the least with macroprolactin. Results: Macroprolactinaemia was found in 62 of 1544 patients (4.02%) who visited an obstetric and gynaecological hospital. The ratio of EIA-determined total PRL to free PRL in the supernatant after PEG precipitation was significantly elevated in all 62 serum samples with macroprolactin compared to those in 1482 serum samples without macroprolactin. In contrast, the ratio of Centaur-determined total PRL to free PRL was significantly elevated in 32 serum samples (group 1) and was within the normal range in 30 (group 2) of 62 serum samples with macroprolactin. The prevalence of non-IgG-type macroprolactin was significantly higher in group 1 than in group 2. Centaur diagnosed hyperprolactinaemia less frequently than EIA (n = 2 vs. 16) in 62 patients with macroprolactinaemia. Those two hyperprolactinaemic patients diagnosed by Centaur had non-IgG-type macroprolactin.

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“…The incidence of macroprolactinemia in every day clinical practice is around 10% 9 , significantly lower than its incidence (l8-42%) in patients with hyperprolactinemia when samples are assayed from reference laboratories [10][11][12] for confirmation of unexpectedly high PRL levels. Macroprolactinemia is seen in both sexes and in children as well as during pregnancy 13 .…”

mentioning

confidence: 98%

“…The large PRL-Ig complex may fail to reach receptors because of limited capacity to cross-vascular endothelium. Although many patients with macroprolactinemia lack typical symptoms of an elevated PRL, there are reports of patients with macroprolactinemia who present with amenorrhea, galactorrhea, and infertility 9,11 . The frequency and clinical consequences of macroprolactinemia have not been clearly established, mainly because of difficulty in identifying these patients.…”

mentioning

confidence: 99%

Macroprolactinemia in a young man and review of the literature

Vassilatou

Schinochoritis²,

Marioli³

et al. 2003

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Macroprolactinaemia: validation and application of the polyethylene glycol precipitation test and clinical characterization of the condition

Cited by 147 publications

References 27 publications

Macroprolactinaemia: a biological diagnostic strategy from the study of 222 patients

Macroprolactinaemia: a biological diagnostic strategy from the study of 222 patients

A possible cause of the variable detectability of macroprolactin by different immunoassay systems

Macroprolactinemia in a young man and review of the literature

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