Macroprolactinemia: A Cause of Hyperprolactinemia in Childhood

Fabre-Brue, C.; Roth, E.; Simonin, G.; Palix, Cassandre; Martin, Pièrre‐Marie; Brue, Thierry

doi:10.1515/jpem.1997.10.4.411

Cited by 15 publications

(16 citation statements)

References 28 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Improved galactorrhea does not indicate that patients were previously exposed to supraphysiologic concentrations of prolactin, because DA treatment also corrects galactorrhea in normoprolactinemic women (29 ). Although the present report is confined to observations in adult women, similar management problems have been reported in men (22 ) and children (30 ).…”

Section: Discussionsupporting

confidence: 55%

Frequent Misdiagnosis and Mismanagement of Hyperprolactinemic Patients before the Introduction of Macroprolactin Screening: Application of a New Strict Laboratory Definition of Macroprolactinemia

Smith²,

et al. 2003

View full text Add to dashboard Cite

Background: Macroprolactin (big big prolactin) has reduced bioactivity and is measured by immunoassays for prolactin when it accumulates in the plasma of some individuals. We applied normative data for serum prolactin after treatment of sera to remove macroprolactin to elucidate the contribution of macroprolactin to misleading diagnoses, inappropriate investigations, and unnecessary treatment. Methods: We reviewed records of women attending a tertiary referral center who had prolactin >1000 mIU/L. Application of a reference interval to polyethylene glycol (PEG)-treated hyperprolactinemic sera identified 21 patients in whom hyperprolactinemia was accounted for entirely by the presence of macroprolactin. Presenting clinical features, diagnoses, and treatment were compared in these patients and 42 age-matched true hyperprolactinemic patients.

show abstract

Section: Discussionsupporting

confidence: 55%

Frequent Misdiagnosis and Mismanagement of Hyperprolactinemic Patients before the Introduction of Macroprolactin Screening: Application of a New Strict Laboratory Definition of Macroprolactinemia

Smith²,

et al. 2003

View full text Add to dashboard Cite

show abstract

“…Although subjects in this study may be too old to determine when macroprolactinaemia began, the current data suggest that macroprolactinaemia is likely to begin before middle age. This assumption is supported by a few reports that demonstrated the presence of macroprolactinaemia in childhood and adolescence (19,20,21).…”

Section: Discussionsupporting

confidence: 53%

The natural history of macroprolactinaemia

Hattori

Adachi

Ishihara

et al. 2012

European Journal of Endocrinology

View full text Add to dashboard Cite

Objective: Macroprolactinaemia is a condition in which serum prolactin (PRL) consists mainly of large molecular weight PRL (macroPRL). The aim of this study was to examine the natural history of macroprolactinaemia. Design and participants: Six hundred and fifty-four hospital workers participated in this study, including 27 subjects with macroprolactinaemia and 627 controls. MacroPRL and serum PRL concentrations were evaluated over a 4-year period. The ratio of macroPRL was examined by the polyethylene glycol (PEG) method and gel filtration chromatography. IgG-bound PRL and anti-PRL autoantibodies were examined by protein G and 125 I-PRL binding studies respectively. Results: Over the 4 years of the study, all 27 macroprolactinaemic subjects had persistent macroprolactinaemia without the development of raised free PRL, while none of the 627 controls developed macroprolactinaemia. The ratios of PEG-precipitable PRL and IgG-bound PRL did not significantly change, but 125 I-PRL binding ratios significantly increased. As a whole, total and free serum PRL concentrations did not significantly change in subjects with macroprolactinaemia over the 4-year period. However, hyperprolactinaemia developed in five of the 18 macroprolactinaemic subjects who were initially normoprolactinaemic along with an increase in anti-PRL autoantibody titres. One of the remaining nine macroprolactinaemic subjects who were initially hyperprolactinaemic showed a decrease in serum PRL concentrations, which occurred concomitantly with a decrease in the anti-PRL autoantibody titre. Conclusions: Macroprolactinaemia may develop before middle age and is likely a chronic condition leading to hyperprolactinaemia.

show abstract

“…Macroprolactinemia has occasionally been shown to occur in several members of the same family [14] and the observation by Jackson et al was in keeping with the hypothesis of maternally transmitted antibodies [15]. Fabre-Brue et al [9] and Fideleff et al [10] checked the brothers of their patients for the presence of hyperprolactinemia, but they had normal PRL concentrations. We also checked the mother of our patient, but she had normal PRL level with no macroprolactinemia.…”

Section: Discussionmentioning

confidence: 72%

“…In 1997, Fabre-Brue et al described four girls with macroprolactinemia. Their initial PRL measurement had been performed as part of a routine endocrine investigation for precocious puberty in 2 cases, short stature in 1 case, and nonspecific headaches in 1 case [9]. Fideleff et al reported 5 asymptomatic cases with macroprolactinemia that was a casual finding.…”

Section: Discussionmentioning

confidence: 99%

“…At first we thought that elevated estrogen levels induced by precocious puberty was the cause of hyperprolactinemia, but this presumption was easily excluded, because high PRL levels persisted despite normalization of E 2 levels 4 months later. After all, the causal relation between macroprolactinemia and precocious puberty was not made clear and it was thought that both had coexisted by chance as was already reported [9,11]. Then, we considered risperidone, serotonine-dopamin-antagonist, as a candidate for the cause of hyperprolactinemia, because PRL secretion is primarily under tonic inhibition by dopamine [12].…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

An Infant Case of Macroprolactinemia with Transient Idiopathic Central Precocious Puberty

et al. 2007

View full text Add to dashboard Cite

Abstract. Macroprolactinemia was recognized more than a decade ago as a cause of hyperprolactinemia and the prevalence of macroprolactinemia is thought to be 10%-26% of patients with hyperprolactinemia. However, there are few published reports about macroprolactinemia in childhood. We report a 7-year-and-1-month-old girl with hyperprolactinemia due to macroprolactinemia with the complication of transient idiopathic central precocious puberty (ICPP). At the age of 6 years and 9 months, she was diagnosed with ICPP at another clinic, on the basis of isolated mammary development and increased height velocity with slightly advanced bone age. At that time, the unexpected finding of high PRL level was also observed. Four months later, she was referred to our clinic for persistently high PRL level. At this time, other endocrinological data showed prepubertal stage and we demonstrated macroprolactinemia and the presence of anti-PRL autoantibody. After other causes of hyperprolactinemia such as prolactinoma and stress were ruled out, we finally diagnosed her with hyperprolactinemia due to macroprolactinemia. Because most patients with macroprolactinemia are symptom-free despite hyperprolactinemia and drug therapy would not be indicated, macroprolactinemia should be suspected even in children to avoid unnecessary examinations and treatments.

show abstract

Macroprolactinemia: A Cause of Hyperprolactinemia in Childhood

Cited by 15 publications

References 28 publications

Frequent Misdiagnosis and Mismanagement of Hyperprolactinemic Patients before the Introduction of Macroprolactin Screening: Application of a New Strict Laboratory Definition of Macroprolactinemia

Frequent Misdiagnosis and Mismanagement of Hyperprolactinemic Patients before the Introduction of Macroprolactin Screening: Application of a New Strict Laboratory Definition of Macroprolactinemia

The natural history of macroprolactinaemia

An Infant Case of Macroprolactinemia with Transient Idiopathic Central Precocious Puberty

Contact Info

Product

Resources

About