Macroprolactinemia: A review of the literature and presentation of clinical cases
https://doi.org/10.62751/2713-0177-2024-5-4-25
Abstract
Macroprolactinemia is considered to be a common cause of hyperprolactinemia. The clinical presentation of patients with macroprolactinemia often has lack of hyperprolactinemic symptoms, and performing a macroprolactin assay can prevent the prescription of unnecessary investigation and treatment. However, there is no definite understanding of whether macroprolactin actually has reduced biological activity compared to the monomeric form of prolactin. Also, due to the autoimmunity of macroprolactin, the question of the possible association of this phenomenon with other autoimmune diseases is relevant. The aim of this review is to analyze the electronic database PubMed, eLIBRARY for articles that included any of the related key words to analyze all the relevant literature on the topic of macroprolactinemia. Two clinical cases of macroprolactinemia in patients with hyperprolactinemia are presented as well.
Supporting agencies: The article was prepared within the framework of the state task “Epidemiological monitoring of common therapeutic diseases, their risk factors and complications in Siberia to improve approaches to their prevention and risk measurement”, 2024–2028 (FWNR-2024-0002)
About the Authors
P. M. Melnikova
Institute of Internal and Preventive Medicine – branch of Institute of Cytology and Genetics, Siberian Branch of Russian Academy of Sciences
Russian Federation
Russian Federation
Polina M. Melnikova, resident doctor
Novosibirsk
O. D. Rymar
Institute of Internal and Preventive Medicine – branch of Institute of Cytology and Genetics, Siberian Branch of Russian Academy of Sciences
Russian Federation
Russian Federation
Oksana D. Rymar, D. Sci. (Med.), chief researcher of the laboratory of clinical-population and preventive studies of therapeutic and endocrine diseases
Novosibirsk
Scopus Author ID: 24339174300
References
1. Costa-Brito A.R., Gonçalves I., Santos C.R.A. The brain as a source and a target of prolactin in mammals. Neural Regen Res. 2022; 17(8): 1695–702. doi: 10.4103/1673-5374.332124.
2. Mousavi MJ, Alizadeh A, Ghotloo S. Interference of B lymphocyte tolerance by prolactin in rheumatic autoimmune diseases. Heliyon. 2023; 9(6): e16977. doi: 10.1016/j.heliyon.2023.e16977.
3. Pirchio R, Graziadio C, Colao A et al. Metabolic effects of prolactin. Front Endocrinol (Lausanne). 2022; 13: 1015520. doi: 10.3389/fendo.2022.1015520.
4. Ramos-Martinez E, Ramos-Martínez I, Molina-Salinas G et al. The role of prolactin in central nervous system inflammation. Rev Neurosci. 2021; 32(3): 323–40. doi: 10.1515/revneuro-2020-0082.
5. Macotela Y, Ruiz-Herrera X, Vazquez-Carrillo DI et al. The beneficial metabolic actions of prolactin. Front Endocrinol (Lausanne). 2022; 13: 1001703. doi: 10.3389/fendo.2022.1001703.
6. Koniares K, Benadiva C, Engmann L et al. Macroprolactinemia: A mini-review and update on clinical practice. F S Rep. 2023; 4(3): 245–50. doi: 10.1016/j.xfre.2023.05л.005.
7. Yang W, Guo Z, Zhou Y et al. Optimization of a screening method for macroprolactinemia. J Chromatogr B Analyt Technol Biomed Life Sci. 2021; 1175: 122723. doi: 10.1016/j.jchromb.2021.122723.
8. Сарибекян А.Г., Петренко Д.А., Трухина Д.А. с соавт. Феномен макро-ТТГ у пациентов с первичным гипотиреозом в исходе аутоиммунного тиреоидита. Клиническая и экспериментальная тиреоидология. 2021; 17(4): 17–20. doi: 10.14341/ket12710.
9. Sharma LK, Dutta D, Sharma N et al. Prevalence of macroprolactinemia in people detected to have hyperprolactinemia. J Lab Physicians. 2021; 13(4): 353–57. doi: 10.1055/s-0041-1732490.
10. Yu C, Fan F, Hu S et al. Evaluation of autoantibodies and immunoglobulin G subclasses in women with suspected macroprolactinemia. J Clin Lab Anal. 2020; 34(11): e23456. doi: 10.1002/jcla.23456.
11. Sostaric M, Bokulic A, Marijancevic D, Zec I. Optimizing laboratory defined macroprolactin algorithm. Biochem Med (Zagreb). 2019; 29(2): 020706. doi: 10.11613/BM.2019.020706.
12. Воротникова С.Ю., Дзеранова Л.К., Федорова Н.С. с соавт. Исследование уровня мономерного пролактина с использованием методики преципитации с полиэтиленгликолем и технологии TRACE. Клиническая лабораторная диагностика. 2021; 66(2): 69–74. doi: 10.51620/0869-2084-2021-66-2-69-74.
13. Hu Y, Ni J, Zhang B et al. Establishment of reference intervals of monomeric prolactin to identify macroprolactinemia in Chinese patients with increased total prolactin. BMC Endocr Disord. 2021; 21(1): 197. doi: 10.1186/s12902-021-00861-z
14. Мельниченко Г.А., Гончаров Н.П., Дзеранова Л.К. с соавт. Клинические и лабораторные аспекты исследования изоформ пролактина методами ПЭГпреципитации и ультрафильтрации. Проблемы эндокринологии. 2010; 56(1): 19–25. doi: 10.14341/probl201056119-25.
15. Rufo E, Martinez-Couselo S, Jimenez-Anon L et al. Marked geographical variation in the prevalence of macroprolactinemia. Clin Chem Lab Med. 2021; 60(3): 71–74. doi: 10.1515/cclm-2021-1124.
16. Che Soh NAA, Yaacob NM, Omar J et al. Global prevalence of macroprolactinemia among patients with hyperprolactinemia: A systematic review and meta-analysis. Int J Environ Res Public Health. 2020; 17(21): 8199. doi: 10.3390/ijerph17218199.
17. Chang S, Copperman AB. New insights into human prolactin pathophysiology: Genomics and beyond. Curr Opin Obstet Gynecol. 2019; 31(4): 207–11. doi: 10.1097/GCO.0000000000000545.
18. Isik S, Berker D, Tutuncu YA et al. Clinical and radiological findings in macroprolactinemia. Endocrine. 2012; 41(2): 327–33. doi: 10.1007/s12020-011-9576-9.
19. Kalsi AK, Halder A, Jain M et al. Prevalence and reproductive manifestations of macroprolactinemia. Endocrine. 2019; 63(2): 332–40. doi: 10.1007/s12020-018-1770-6.
20. Krysiak R, Kowalcze K, Okopien B. Macroprolactinemia attenuates the impact of levothyroxine on hypothalamic-pituitary-thyroid axis activity and thyroid autoimmunity in women with autoimmune hypothyroidism. J Clin Pharmacol. 2020; 60(11): 1496–501. doi: 10.1002/jcph.1655.
21. Rosen R, Brown C, Heiman J et al. The Female Sexual Function Index (FSFI): A multidimensional self-report instrument for the assessment of female sexual function. J Sex Marital Ther. 2000; 26(2): 191–208. doi: 10.1080/009262300278597.
22. Beck AT, Steer RA, Brown GK. Manual for the Beck depression inventory-II. San Antonio, TX: Psychological Corporation. 1996; 38 pp. ISBN-10: 0158018389.
23. Krysiak R, Drosdzol-Cop A, Skrzypulec-Plinta V, Okopien B. Sexual function and depressive symptoms in young women with elevated macroprolactin content: A pilot study. Endocrine. 2016; 53(1): 291–98. doi: 10.1007/s12020-016-0898-5.
24. Malarkey WB, Jackson R, Wortsman J. Long-term assessment of patients with macroprolactinemia. Fertil Steril. 1988; 50(3): 413–18. doi: 10.1016/S0015-0282(16)60124-3.
25. Lewandowski KC, Gąsior-Perczak D, Kowalska A, Lewinski A. Prevalence of macroprolactinaemia in regularly menstruating women with non-toxic goitre or autoimmune thyroid disease. Thyroid Res. 2012; 5(1): 20. doi: 10.1186/1756-6614-5-20.
26. Guclu M, Cander S, Kiyici S et al. Serum macroprolactin levels in pregnancy and association with thyroid autoimmunity. BMC Endocr Disord. 2015; 15: 31. doi: 10.1186/s12902-015-0025-2.
27. Leanos-Miranda A, Pascoe-Lira D, Chavez-Rueda KA, Blanco-Favela F. Detection of macroprolactinemia with the polyethylene glycol precipitation test in systemic lupus erythematosus patients with hyperprolactinemia. Lupus. 2001; 10(5): 340–45. doi: 10.1191/096120301672772070.
28. Kramer CK, Tourinho TF, de Castro WP, da Costa Oliveira M. Association between systemic lupus erythematosus, rheumatoid arthritis, hyperprolactinemia and thyroid autoantibodies. Arch Med Res. 2005; 36(1): 54–58. doi: 10.1016/j.arcmed.2004.11.007.
29. Gladman DD, Ibanez D, Urowitz MB. Systemic lupus erythematosus disease activity index 2000. J Rheumatol. 2002; 29(2): 288–91.
30. Toffoli Ribeiro C, Louzada Junior P, de Sa MF. Correlation between systemic lupus erythematosus activity and plasma levels of monomeric prolactin and macroprolactin. Endocr Metab Immune Disord Drug Targets. 2016; 16(1): 21–27. doi: 10.2174/1871530315666151020101518.
31. Jokar M, Tayyebi Maybodi N, Amini A, Hatef Fard M. Prolactin and macroprolactin in patients with systemic lupus erythematosus. International Journal of Rheumatic Diseases. 2008; 11(3): 257–62. doi: 10.1111/j.1756-185X.2008.00378.x.
32. Kavanagh-Wright L, Smith TP, Gibney J, McKenna TJ. Characterization of macroprolactin and assessment of markers of autoimmunity in macroprolactinaemic patients. Clin Endocrinol (Oxf). 2009; 70(4): 599–605. doi: 10.1111/j.1365-2265.2008.03402.x.
33. Рымар О.Д., Воевода С.М., Шахтшнейдер Е.В. с соавт. Частота метаболического синдрома и его отдельных компонентов у женщин 25–45 лет в зависимости от уровня пролактина. Ожирение и метаболизм. 2021; 18(2): 180–189. doi: 10.14341/omet12475.
34. Krysiak R, Szkrobka W, Okopien B. Cardiometabolic risk factors in men with elevated macroprolactin content: A pilot study. Exp Clin Endocrinol Diabetes. 2021; 129(1): 7–13. doi: 10.1055/a-0902-4439.
35. Krysiak R, Marek B, Okopien B. Cardiometabolic risk factors in young women with macroprolactinaemia. Endokrynol Pol. 2019; 70(4): 336–41. doi: 10.5603/EP.a2019.0013.
36. Krysiak R., Kowalska B., Szkrobka W., Okopien B. The association between macroprolactin levels and vitamin D status in premenopausal women with macroprolactinemia: A pilot study. Exp Clin Endocrinol Diabetes. 2015; 123(8): 446–50. doi: 10.1055/s-0035-1555877.
37. Landberg E, Dahlstrom U, Alehagen U. Serum prolactin and macroprolactin in heart failure: No relation to established laboratory or clinical parameters. Ann Clin Biochem. 2011; 48(Pt 1): 51–56. doi: 10.1258/acb.2010.010164.
38. Anaforoglu I, Ertorer ME, Kozanoglu I et al. Macroprolactinemia, like hyperprolactinemia, may promote platelet activation [published correction appears in Endocrine. 2010; 37(2): 301–2. Endocrine. 2010; 37(2): 294–300. doi: 10.1007/s12020-009-9304-x.
39. Delcour C, Robin G, Young J, Dewailly D. PCOS and hyperprolactinemia: What do we know in 2019? Clin Med Insights Reprod Health. 2019; 13: 1179558119871921. doi:10.1177/1179558119871921.
40. Davoudi Z, Araghi F, Vahedi M et al. Prolactin level in polycystic ovary syndrome (PCOS): An approach to the diagnosis and management. Acta Biomed. 2021; 92(5): e2021291. doi:10.23750/abm.v92i5.9866.
41. Hayashida A, Marcondes JA, Soares JM Jr et al. Evaluation of macroprolactinemia in 259 women under investigation for polycystic ovary syndrome. Clin Endocrinol (Oxf). 2014; 80(4): 616–18. doi:10.1111/cen.12266.
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For citations:
Melnikova P.M., Rymar O.D. Macroprolactinemia: A review of the literature and presentation of clinical cases. FOCUS. Endocrinology. 2024;5(4):106-112. (In Russ.) https://doi.org/10.62751/2713-0177-2024-5-4-25
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