I receive many requests for measurement of macroprolactin. Most of the measurement results of this prolactin samples are within the reference range. In these cases, is there some significance to clinical measurement macroprolactin?
I only measure macroprolactin in cases of moderately increased prolactine levels in the absense of any classical symptoms.
I determined macroprolactin only if value of prolactin concentration is above upper limit of the reference interval (by age and sex) regardless of clinical symptoms exist or not (which we often did not fully known). Accurate values are becoming important for later when we follow up the patient (therapy, contraception, etc.).
Also, the second generation of reagents for CLIA method of prolactin determination (with two antibodies for prolactin), almost and practically eliminates the need to determine macroprolactin.
Hi Jasna,
In the ECLIA method of prolactin (Elecsys and Cobas, Roche) is recommended to determine macroprolactin.
Yes, but number of cases with high concentration is significantly lower. In my practice with adolescents and young women, determination of prolactin with new generation of prolactine reagents (Cobas, Roche) reduced the high (and "mild" elevated levels) levels of prolactin and thus the need for determination of macroprolactin is reduced almost in half. Also, high scores, and prolactin after deproteinization remain high.
Also, our experiences I have described and presented as a poster at the 17th IFCC FESCC European Congress of Clinical Chemistry and Laboratory Medicine, EuroMedLab 2007th (Abstract in Clin Chem Lab Med 2007, 45 (Suppl. 1): S181) and also you can see on my researchgate profil (link: https://www.researchgate.net/publication/244476144_Hyperprolactinemia_and_macroprolactinemia_in_adolescent._Our_experience_and_dilemma?ev=prf_pub )
Conference Paper Hyperprolactinemia and macroprolactinemia in adolescent. Our...
Thank you, Jasna.
I know endocrinologists who still request determination of macroprolactin. Apparently, the physicians who perform outpatient does not have a close relationship with the clinical laboratory, resulting in lack of knowledge of new generation of methods and improvement in specificity and sensitivity.
Dear Macros Borges,
It was my pleasure. If you still need help - ask me.
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