Screening for macroprolactinaemia and pituitary imaging studies

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dc.contributor.authorHauache, Omar Magid [UNIFESP]
dc.contributor.authorRocha, A. J.
dc.contributor.authorMaia, ACM
dc.contributor.authorMaciel, Rui Monteiro de Barros [UNIFESP]
dc.contributor.authorVieira, José Gilberto Henriques [UNIFESP]
dc.contributor.institutionUniversidade Federal de São Paulo (UNIFESP)
dc.date.accessioned2016-01-24T12:33:30Z
dc.date.available2016-01-24T12:33:30Z
dc.date.issued2002-09-01
dc.description.abstractOBJECTIVE Hyperprolactinaemia is caused by high levels of monomeric, dimeric or macro forms of prolactin in circulation, the monomeric form being predominant in patients with prolactinomas. Macroprolactinaemia, however, is common and is associated with asymptomatic cases. in this study, we reviewed our records regarding clinical and imaging investigations in patients who were found to have hyperprolactinaemia predominantly due to the presence of macroprolactin and compared them with the findings observed in patients whose prolactin molecular size consisted predominantly of the monomeric form.PATIENTS and METHODS We conducted a retrospective study of 113 consecutive patients (nine men and 104 women, aged 19-67 years, median age 39 years) with hyperprolactinaemia who were screened for the presence of macroprolactin by polyethylene glycol precipitation and/or chromatography and submitted to pituitary magnetic resonance imaging (MRI) and/or computerized tomography (CT).RESULTS Fifty-two of 113 patients (46%) had hyperprolactinaemia due to macroprolactin, whereas the remaining 61 patients (54%) had their hyperprolactinaemia confirmed by the predominance of the monomeric form. Both groups shared similar mean prolactin levels (79.9 +/- 63.6 mug/l, median of 62.0 mug/l, and 97.9 +/- 155.4 mug/l, median of 61.0 mug/l, respectively). of the patients with macroprolactinaemia, 46% had no symptoms of hyperprolactinaemia, whereas only 10% of the patients who screened negative for macroprolactin were asymptomatic. There was an association between macroprolactinaemia and negative pituitary imaging findings: normal pituitary images were found in 78.9% of patients who had macroprolactinaemia and in 25% of patients with monomeric hyperprolactinaemia. in addition, none of the patients with macroprolactinoma (seven cases) had macroprolactinaemia.CONCLUSIONS the presence of macroprolactinaemia does not exclude the possibility of a pituitary adenoma and consequently may not prevent pituitary imaging studies. However, our data demonstrate that all asymptomatic patients who screened positive for macroprolactin had normal pituitary imaging studies. Patient samples showing hyperprolactinaemia should be first tested for macroprolactin, before the patient is submitted to imaging studies. We suggest that imaging studies should be ordered in patients with macroprolactinaemia when indicated by clinically relevant features. As a result, unnecessary anxiety and costly medical procedures may be prevented.en
dc.description.affiliationUniversidade Federal de São Paulo, Fleury Diagnost Ctr, Dept Endocrinol, São Paulo, Brazil
dc.description.affiliationUniversidade Federal de São Paulo, Fleury Diagnost Ctr, Dept Radiol, São Paulo, Brazil
dc.description.affiliationUniversidade Federal de São Paulo, Dept Med, Div Endocrinol, São Paulo, Brazil
dc.description.affiliationUnifespDepartments of Endocrinology and Division of Endocrinology, Department of Medicine, Universidade Federal de São Paulo, São Paulo, Brazil
dc.description.sourceWeb of Science
dc.format.extent327-331
dc.identifierhttp://dx.doi.org/10.1046/j.1365-2265.2002.01586.x
dc.identifier.citationClinical Endocrinology. Oxford: Blackwell Publishing Ltd, v. 57, n. 3, p. 327-331, 2002.
dc.identifier.doi10.1046/j.1365-2265.2002.01586.x
dc.identifier.issn0300-0664
dc.identifier.urihttp://repositorio.unifesp.br/handle/11600/26968
dc.identifier.wosWOS:000177747500004
dc.language.isoeng
dc.publisherBlackwell Publishing Ltd
dc.relation.ispartofClinical Endocrinology
dc.rightsinfo:eu-repo/semantics/restrictedAccess
dc.titleScreening for macroprolactinaemia and pituitary imaging studiesen
dc.typeinfo:eu-repo/semantics/article
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