Macroprolactinemia phenomenon

Prolactin (PRL) is present in the serum as different isoforms: monomolecular with high receptor and biological activities; macropro-lactin (an immune complex of a PRL molecule with autoantibodies) has a low affinity for receptors and a tow biological activity, are slowly cleared from the body, and may accumulate abundantly in the latter. The incidence of the macroprolactinemia phenomenon was explored, by analyzing the PRL isoforms studied in 160 patients with hyperprolactinemia. The study was conducted on an Elexia 2010 electric chemiluminescence analyzer at the biochemical laboratory of the Voronezh Regional Diagnostic Center. The monomolecular PRL level of 60% or more was found in 111 patients and regarded as the absence of macroprolactinemia; that of less than 40% was determined in 41 patients (macroprolactinemia) and that of 40 to 60% in 8 patients (an equivocal result). There was no linkage of the presence of macroprolactinemia to age and gender. The maximum frequency of this phenomenon (50% of cases) was recorded at the PRL level of 1000 to 2000 IU/I. In this group of patients, the concentration of PRL was 3.5 to 36% after polyethylene glycol treatment. By taking into account the sufficient spread of the signs characteristic of the hyperprolactinemic syndrome in the population, on the one hand, and the high prevalence, origin, and properties of macroprolactinemia in the population of patients having the elevated level of PRL, on the other hand, the introduction of a study of PRL isoforms into the algorithm of diagnostic search makes it possible to extend the capacities of a differential diagnosis of different forms of hyperprolactinemla, to exclude unnecessary tests, and to prevent inadequate drug therapy or surgical intervention when they are resistant to the treatment performed.

1. УДК 616.154:577.175.3281-008.61

2. Вакс В. В. // Consilium Medicum. - 2001. - Т. 3, № П.

3. Гончаров Н. П., Добрачева А. Д., Колесникова Г. С, Дзеранова Л. К. // Андрол. и генитальная хир. - 2005. - № 3. - С. 34-39.

4. Дедов И. И., Мельниченко Г. А., Романцева Т. И. Синдром гиперпролактинемии. - М., 2004.

5. Окороков А. Н. Диагностика болезней внутренних органов. - М., 2001.

6. Осипова А. А. // Consilium Medicum. - 2002. - Т. 4, № 8.

7. Романцова Т. И., Мельниченко Г. А., Черноголов В. А. // Гинекология. - 1999. - Т. 1, № 2.

8. Ann D., Hewlett Т. // Endocrinol. Metab. Clin. N. Am. - 2000. - Vol. 29. - P. 205-221.

9. Blanco-Faveta F., Chaves-Rueda K., Leanos-Miranda A. // Lupus. - 2001. - Vol. 10, N 10. - P. 757-761.

10. De Schepper J., Schlettecatle J., Veikenlers B. et al. // Eur. i. Endocrinol. - 2003. - Vol. 149, N 3. - P. 201-217.

11. Hattori N. // J. Pharmacol. Sci. - 2003. - Vol. 92, N 3. -P. 171-177.

12. Leslie Н., Courtner C. Н, Bell P. M. et al. // J. Clin. Endocrinol. Metab. - 2001. - VoL 86. - P. 2743-2746.

13. Schlechte J. A. // J. Clin. Endocrinol. Metab. - 2002. -Vol. 87, N 12. - P. 5408-5409.

14. Schneider W et al. // Clin. Biochem. - 2001. - Vol. 34. -P. 469-473.

15. Smith T. P., Suliman A. M., Fahie-Wibon M. N.. McKenna T. J. // J. Clin. Endocrinol. Metab. - 2002. - Vol. 87. -P. 5410-5415.

16. Valdemanson S. // Lacartidningen. - 2004. - Vol. 5. - P. 458-465.

17. Vallette-Kasic S., Morange-Ramos I., Selim A. et al. // J. Clin. Endocrinol. Metab. - 2002. - Vol. 87. - P. 2121-2127.

18. Инструкция в упаковке к набору "Элексис пролактин" Roche Diagnostics.