Macroprolactin: From laboratory to clinical practice
Por:
Biagetti, B, Costa, RF, Guerra, RA, Garcia, EA, Escalera, EB, Casals, G, Salan, ME, Ibern, MLG, Ramos, JG, Lazareno, NL, Oriola, J, Martinez, PMS, Quesada, MET, Rull, EU, Lacalle, CG
Publicada:
1 ene 2022
Resumen:
Prolactin measurement is very common in standard clinical practice. It is indicated not only in the study of pituitary adenomas, but also when there are problems with fertility, decreased libido, or menstrual disorders, among other problems. Inadequate interpretation of prolactin levels without contextualizing the laboratory results with the clinical, pharmacological, and gynecological/urological history of patients leads to erroneous diagnoses and, thus, to poorly based studies and treatments. Macroprolactinemia, defined as hyperprolactinemia due to excess macroprolactin (an isoform of a greater molecular weight than prolactin but with less biological activity), is one of the main causes of such erroneous diagnoses, resulting in poor patient management when not recognized. There is no unanimous agreement as to when macroprolactin screening is required in patients with hyperprolactinemia. At some institutions, macroprolactin testing by polyethylene glycol (PEG) precipitation is routinely performed in all patients with hyperprolactinemia, while others use a clinically based approach. There is also no consensus on how to express the results of prolactin/macroprolactin levels after PEG, which in some cases may lead to an erroneous interpretation of the results. The objectives of this study were: 1. To establish the strategy for macroprolactin screening by serum precipitation with PEG in patients with hyperprolactinemia: universal screening versus a strategy guided by the alert generated by the clinician based on the absence or presence of clinical symptoms or by the laboratory when hyperprolactinemia is detected. 2. To create a consensus document that standardizes the reporting of prolactin results after precipitation with PEG to minimize errors in the interpretation of the results, in line with international standards. (c) 2021 SEEN y SED. Published by Elsevier Espana, S.L.U. All rights reserved.
Filiaciones:
Biagetti, B:
Univ Autonoma Barcelona, Hosp Univ Vall Dhebron, Serv Endocrinol & Nutr, Barcelona, Spain
Costa, RF:
Univ Autonoma Barcelona, Hosp Univ Vall dHebron, Serv Bioquim, Lab Clin, Barcelona, Spain
Guerra, RA:
Hosp Gen Univ Alicante, Lab Anal Clin, Alicante, Spain
Garcia, EA:
CHU Vigo, Serv Anal Clin, Hosp Meixoeiro, Vigo, Pontevedra, Spain
Escalera, EB:
Hosp Univ Sabadell, Lab Parc Tauli, Barcelona, Spain
Casals, G:
Hosp Clin Univ, Serv Bioquim & Genet Mol, IDIBAPS, Barcelona, Spain
Salan, ME:
Hosp Univ Cruces, Lab Bioquim, Baracaldo, Vizcaya, Spain
Ibern, MLG:
Univ Autonoma Barcelona, Hosp Univ Germans Trias I Pujol, Serv Bioquim Clin, Barcelona, Spain
Ramos, JG:
Hosp Gen Univ Gregorio Maranon, Serv Boquim, Lab Hormonas & Biomarcadores, Madrid, Spain
Lazareno, NL:
Hosp Gen Univ Gregorio Maranon, Serv Boquim, Lab Hormonas & Biomarcadores, Madrid, Spain
Oriola, J:
Hosp Clin Univ, Serv Bioquim & Genet Mol, IDIBAPS, Barcelona, Spain
Martinez, PMS:
Hosp Univ Virgen Macarena, Unidad Gest Clin Bioquim Clin, Seville, Spain
Quesada, MET:
Hosp Gen Univ Alicante, Serv Anal Clin, Lab Hormonas, Alicante, Spain
Rull, EU:
Hosp Santa Creu & Sant Pau, Serv Bioquim, Barcelona, Spain
Lacalle, CG:
Hosp Univ Severo Ochoa, Serv Anal Clin, Madrid, Spain
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