Sharma Lokesh Kumar, Dutta Deep, Sharma Neera, Kulshreshtha Bindu, Lal Sandhya, Sethi Ritika
Department of Biochemistry, Atal Behari Vajpayee Institute of Medical Sciences (ABVIMS) and Dr Ram Manohar Lohia (RML) Hospital, New Delhi (formerly Postgraduate Institute of Medical Education & Research [PGIMER] and Dr RML Hospital, New Delhi), India.
Department of Endocrinology, CEDAR Superspeciality Healthcare, New Delhi, India.
J Lab Physicians. 2021 Jul 12;13(4):353-357. doi: 10.1055/s-0041-1732490. eCollection 2021 Dec.
Macroprolactinemia is an analytic laboma encountered as a part of prolactin assay. No data are available on the burden of macroprolactinemia in Indians. This study aimed to determine the prevalence and predictors of macroprolactinemia among people with hyperprolactinemia. Consecutive patients detected to have serum prolactin > 18 ng/mL as per the upper reference limit were further screened for macroprolactin by post-polyethylene-glycol (PEG)-precipitation test. Macroprolactinemia was defined as post-PEG recovery of prolactin < 40%. The four most common underlying etiologies for the testing of hyperprolactinemia were polycystic ovary syndrome ( = 402; 32.71%), pituitary adenomas ( = 318; 25.87%), drug-induced hyperprolactinemia ( = 224; 18.23%), and infertility ( = 126; 10.25%). A total of 1,229 patients (male:female = 191:1038) having mean age 30.46 ± 10.14 years had hyperprolactinemia, of which 168 (13.7%) were diagnosed to have macroprolactinemia. Macroprolactinemia was significantly higher in females than males (15.03 vs. 6.28%; < 0.001). Age quartile-based analysis revealed no difference in occurrence of macroprolactinemia. Only 34 patients (2.76%) with macroprolactinemia (< 40% recovery of prolactin post-PEG precipitation) had raised prolactin levels after recovery. These patients primarily had underlying pituitary pathology. Macroprolactinemia is not uncommon in people being tested for hyperprolactinemia. We should not hesitate to screen for macroprolactinemia in patients who have incidentally been detected to have hyperprolactinemia.
巨泌乳素血症是催乳素检测过程中遇到的一种分析性假象。目前尚无关于印度人群中巨泌乳素血症负担的数据。本研究旨在确定高催乳素血症患者中巨泌乳素血症的患病率及预测因素。根据上限参考值，连续检测出血清催乳素>18 ng/mL的患者，通过聚乙二醇（PEG）沉淀后试验进一步筛查巨泌乳素。巨泌乳素血症定义为PEG沉淀后催乳素回收率<40%。检测高催乳素血症的四种最常见潜在病因是多囊卵巢综合征（n = 402；32.71%）、垂体腺瘤（n = 318；25.87%）、药物性高催乳素血症（n = 224；18.23%）和不孕症（n = 126；10.25%）。共有1229例患者（男∶女 = 191∶1038）患有高催乳素血症，平均年龄30.46±10.14岁，其中168例（13.7%）被诊断为巨泌乳素血症。女性巨泌乳素血症显著高于男性（15.03%对6.28%；P<0.001）。基于年龄四分位数的分析显示巨泌乳素血症的发生率无差异。只有34例（2.76%）巨泌乳素血症患者（PEG沉淀后催乳素回收率<40%）恢复后催乳素水平升高。这些患者主要有潜在的垂体病变。在接受高催乳素血症检测的人群中，巨泌乳素血症并不少见。对于偶然检测出高催乳素血症的患者，我们应毫不犹豫地筛查巨泌乳素血症。
