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Choi, Kang, Kim, Hong, Kim, Shin, Kim, Cho, and Lee: The Clinical Characteristics of Macroprolactinemia
Original Article
Journal of Korean Society of Endocrinology

Journal of Korean Society of Endocrinology 2005; 20(3): 216-223.

Published online: 20 June 2005

DOI: https://doi.org/10.3803/jkes.2005.20.3.216

The Clinical Characteristics of Macroprolactinemia

Young Ju Choi, Jun Goo Kang, Sung Yeon Kim, Eui Sil Hong, Sang Wan Kim, Chan Soo Shin, Seong Yeon Kim, Bo Youn Cho, Hong Kyu Lee

Department of Internal Medicine, Seoul National University College of Medicine, Seoul National University Hospital Seoul, Korea.

Received 31 January 2005       Accepted 16 March 2005

Copyright © 2005 Korean Endocrine Society

Abstract

Background

Prolactin has been identified by gel chromatography to exist is three different forms in human serum; monomeric prolactin (molecular mass 23 kDa), big prolactin (molecular mass 50~60 kDa) and big big prolactin, otherwise known as macroprolactin (molecular mass 150~170 kDa). The predominance of macroprolactinemia has long been known in idiopathic hyperprolactinemic patients with maintained fertility. In recent reports, 24% of microprolactinoma patients showed no menstrual disturbances, which was suggestive of macroprolactinemia. The purpose of this study was to evaluate: (1) the frequency of macroprolactinemia among idiopathic hyperprolactinemia and prolactinoma patients, (2) the difference in the clinical characteristics between hyperprolactinemia, with and without macroprolactinemia, among idiopathic hyperprolactinemia and prolactinoma patients, and (3) the follow-up prolactin level using the bromocriptine response.

Methods

We retrospectively analyzed the clinical characteristics and prolactin levels in 43 idiopathic hyperprolactinemia and 51 prolactinoma patients with a poor bromocriptine response. Macroprolactinemia was identified by the prolactin recovery of < 40% using the polyethylene glycol (PEG) precipitation test.

Results

(1) Of the 43 idiopathic hyperprolactinemia and 51 prolactinoma patients, 17 (39.5%) and 9 (17.6%), respectively, were macroprolactinemic (P < 0.05).
(2) Among the idiopathic hyperprolactinemia patients, galactorrhea combined with amenorrhea was significantly less frequent (P < 0.05), with the 1- and 2-year follow-up prolactin levels being significantly higher in those with macroprolactinemia than monomeric prolactinemia (P < 0.05).
(3) Among the prolactinoma patients, amenorrhea was significantly less frequent (P < 0.05), but asymptomatic cases were more frequent in those with macroprolactinemia than monomeric prolactinemia (P < 0.05). The 1- and 2-year follow-up prolactin levels were significantly higher in those with macroprolactinemia than monomeric prolactinemia (P < 0.05).

Conclusion

The screening of macroprolactinemia should be considered in idiopathic hyperprolactinemia and prolactinoma patients with a poor bromocriptine response

Keywords: Macroprolactinemia, Idiopathic hyperprolactinemia, Prolactinoma

Figures and Tables

Fig. 1
Comparison of long-term follow-up of prolactin levels in macroprolactinemia with monomeric prolactinemia among the patients of idiopathic hyperprolactinemia (*: P < 0.05)
jkse-20-216-g001
Fig. 2
Comparison of response of bromocripine in macroprolactinemia with monomeric prolactinemia among the patients of prolactinoma (*: P < 0.05)
jkse-20-216-g002
Table 1
Clinical Characteristics of Study Subjects
jkse-20-216-i001

values are mean ± SD.

NS: not significant

Table 2
Comparison of Clinical Characteristics and Prolactin Level Between Macroprolactinemia and Monomeric Prolactinemia Among the Patients of Idiopathic Hyperprolactinemia
jkse-20-216-i002

values are mean ± SD.

NS: not significant

G + A: galatorrhea+amenorrhea

Table 3
Comparison of Clinical Characteristics and Prolactin Level Between Macroprolactinemia and Monomeric Prolactinemia Among the Patients of Prolactinoma
jkse-20-216-i003

values are mean ± SD.

NS: not significant

G + A: galatorrhea+amenorrhea

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