The frequency of macroprolactinemia among patients with hyperprolactinemia in a central laboratory of a training and research hospital

OBJECTIVE: Macroprolactinemia is a well-described endocrine disorder, with its results leading to unnecessary tests and overtreatment. However, routine macroprolactin screening is not performed in many laboratories. Routinely used prolactin assays can result in false diagnosis of hyperprolactinemia in patients with no signs and symptoms related to hyperprolactinemia and clinicians should be aware of macroprolactinemia frequency encountered with the method in use. In this study, it was aimed to examine the frequency of macroprolactinemia among patients with hyperprolactinemia.
METHODS: Prolactin analyses were performed on Roche Cobas® e801 immunoanalyzer using the Elecsys Prolactin II electrochemiluminesence immunoassay (Roche Diagnostics, Mannheim, Germany). Samples were provided from 14 different hospitals in total and evaluated with the same method in a single central laboratory. In order to precipitate the samples for macroprolactin analysis, polyethylene glycol (PEG) 6000 was used.
RESULTS: In this study, we evaluated 1100 patients with hyperprolactinemia and determined the frequency of macroprolactinemia to be 9.6% (recovery cut-off value <40%), while 8.5% of the patients were in the gray zone (recovery cut-off value 40% to <60%).
CONCLUSION: Laboratories should consider regularly screening for macroprolactinemia in all hyperprolactinemic samples and collaborate with clinicians to raise awareness about the prevalence of this condition.

Bir eðitim ve araþtýrma hastanesi merkez laboratuvarýnda hiperprolaktinemili hastalarda makroprolaktinemi sýklýðý

Amaç: Makroprolaktinemi gereksiz testlere ve uygunsuz tedaviye yol açabilen, iyi tanýmlanmýþ bir endokrin bozukluktur. Bununla birlikte birçok laboratuvarda rutin makroprolaktin ölçümü yapýlmamaktadýr. Rutin olarak kullanýlan prolaktin testleri, belirti ve bulgularý olmayan hiperprolaktinemili hastalarda yanlýþ hiperprolaktinemi tanýsýna yol açabilmektedir. Klinisyenlerin, kullanýlan yöntemle, karþýlaþýlan makroprolaktinemi sýklýðý konusunda dikkatli olmalarý gerekmektedir. Bu çalýþmada hiperprolaktinemili hasta grubunda makroprolaktinemi sýklýðýný araþtýrmayý amaçladýk.
Yöntemler: Prolaktin analizleri, Elecsys Prolactin II elektrokemilüminesans immunoassay testi (Roche Diagnostics, Mannheim, Almanya) kullanýlarak Roche Cobas® e801 immunoassay cihazýnda gerçekleþtirildi. Toplamda 14 farklý hastaneden alýnan numuneler, tek bir merkezi laboratuvarda ayný yöntemle incelendi. Makroprolaktin analizi için numuneler polietilen glikol (PEG) 6000 kullanýlarak çöktürüldü.
Bulgular: Bu çalýþmada hiperprolaktinemili 1100 hastayý deðerlendirdik. Makroprolaktinemi sýklýðýný %9,6 (geri kazaným yüzdesi <%40) olarak belirlerken, hastalarýn %8,5'inin gri bölgede (geri kazaným yüzdesi (%40 - <%60) olduðunu saptadýk.
Sonuç: Laboratuvarlar tüm hiperprolaktinemik serumlarda rutin makroprolaktin çalýþmayý deðerlendirmeli ve bu konunun sýklýðý konusunda farkýndalýðý artýrmak için klinisyenlerle iletiþim halinde olmalýdýrlar. (NCI-2023-10-11)