Endocrine Abstracts

Recently, the phenomenon of macroprolactinaemia has manifested itself into a great interest for physicians. This problem forces both physicians and patient to waste sizeable resources, and can lead to iatrogenic and unjustified emotional stress and further material losses. At the same time the problem of differential diagnostics of pseudoprolactinomas and true prolactinomas remains challenging. The purpose of the present study was to determine the clinic-analytical repercussion of the presence of maPRL in female patients with hyperprolactinaemia.

The patients and methods: 321 patients with hyperprolactinaemia (PRL level was more than 700 mU/l) were examined (36 male and 285 female). The age mediana was 29±3 years. The quantitative estimation of biologically active monomeric PRL was conducted. A polyethylene glycol (PEG) precipitation test (Delfia System) was used to detect the presence of maPRL in all consecutive samples with prolactin levels >700 mU\L). A recovery <60% was taking as indicating of maPRL.

The results: maPRL was found in 57 (18%) of 321 patients with total PRL>700 mU\l; all other 264 patients (82%) had maPRL below 60%. Mediana of PRL level in the group with macroprolactinaemia was – 1167 mU/l (700–1635); the mediana of maPRL-997 mU/l (700–1295). The most frequent reason for the initial PRL request was menstrual disturbance (36.8% patients). As for clinical presentations, Galactorrhea was noted in 19.2% cases; the headaches -in 38.5% patients, the increasing of the mass of the body in 24.5% of cases. The microadenomas were revealed in 38.7% events, and macroadenomas – in 4.5% cases.

The conclusion: Macroprolactinaemia is a frequent condition. The estimation of PRL fractions is an important problem and nessesary for diagnostic mistakes elimination, to avoid the unnecessary diagnostic procedures, to the needless medical treatment or surgery prevention. The determination of maPRL in routine studies is recommended.