Lewandowski Krzysztof C, Gasior-Perczak Danuta, Kowalska Aldona, Lewinski Andrzej
Department of Endocrinology & Metabolic Diseases, Medical University of Lodz & Polish Mother's Memorial Hospital Research Institute , Lodz , Poland and.
Gynecol Endocrinol. 2014 May;30(5):385-7. doi: 10.3109/09513590.2014.887672. Epub 2014 Feb 17.
Macroprolactin may cause elevation of prolactin (PRL) concentrations measured by standard assays. In our study, we assessed the prevalence of pituitary lesions in women with macroprolactinaemia and either oligomenorrhoea or secondary amenorrhoea. Pituitary MRI scans were performed in 61 women aged 31.0 ± 6.7 years (mean ± SD), with raised PRL concentrations due to macroprolactinaemia, detected by 25% polyethylene glycol (PEG) precipitation method (PRL recovery <40%). After PEG precipitation of macroprolactin, free PRL concentrations were still raised in 36 (59%) women. Microadenomas were detected in 10 patients out of 61 (16.4%), with raised free PRL in 9 of these cases, while macroadenomas were detected in 4 out of 61 (6.6%) women, all of whom also had raised free PRL. In case of coexistence of macroprolactinaemia and raised free PRL after PEG precipitation of macroprolactin, the chance of finding of either a micro- or a macroadenoma was 36% (13 cases out of 36). We conclude that hyperprolactinaemia and macroprolactinaemia may coexist in the same patient. Furthermore, if free PRL is raised after PEG precipitation of macroprolactin, then the chance of finding either a pituitary micro- or macroadenoma in women with oligo-/amenorrhoea is over 30%. Therefore pituitary magnetic resonance imaging is mandatory in all such cases.
巨泌乳素可能会导致通过标准检测方法测得的泌乳素（PRL）浓度升高。在我们的研究中，我们评估了患有巨泌乳素血症且伴有月经过少或继发性闭经的女性垂体病变的患病率。对61名年龄为31.0 ± 6.7岁（均值 ± 标准差）的女性进行了垂体MRI扫描，这些女性因巨泌乳素血症导致PRL浓度升高，通过25%聚乙二醇（PEG）沉淀法检测（PRL回收率<40%）。在对巨泌乳素进行PEG沉淀后，36名（59%）女性的游离PRL浓度仍然升高。61名患者中有10名（16.4%）检测出微腺瘤，其中9例游离PRL升高，而61名女性中有4名（6.6%）检测出大腺瘤，所有这些患者的游离PRL也都升高。在巨泌乳素血症并存且巨泌乳素经PEG沉淀后游离PRL升高的情况下，发现微腺瘤或大腺瘤的几率为36%（36例中有13例）。我们得出结论，高泌乳素血症和巨泌乳素血症可能在同一患者中并存。此外，如果巨泌乳素经PEG沉淀后游离PRL升高，那么在患有月经过少/闭经的女性中发现垂体微腺瘤或大腺瘤的几率超过30%。因此，在所有此类病例中，垂体磁共振成像检查是必不可少的。
