Human Reproduction, Vol. 18, No. 4, 853-857,
April 2003
© 2003 European Society of Human Reproduction and Embryology
Macroprolactinaemia associated with prolactin adenoma
1 Service d’Endocrinologie and 2 Service de Neurochirurgie, Hôpital Bellevue, 42055 Saint-Etienne Cedex 2, France, 3 Laboratoire d’Histologie Embryologie moléculaires and INSERM U433, Faculté de Médecine Lyon–RTH Laennec, 69372 Lyon Cedex 08, France and 4 Service de Radiopharmacie et de Radioanalyses, Hôpital Neurologique et Cardiologique, 69394 Lyon Cedex 03, France
5 To whom correspondence should be addressed. e-mail: lhem{at}laennec.univ-lyon1.fr
BACKGROUND: Macroprolactinaemia, defined as hyperprolactinaemia with a predominance of, or only, the big big prolactin (bbPRL) isoform, is considered idiopathic and poorly symptomatic. Since its association with a PRL adenoma is poorly documented, we examined a series of 13 patients with tumoral hyperprolactinaemia for the presence of macroprolactinaemia. METHODS: From a series of 36 patients with hyperprolactinaemia studied for PRL isoforms, we selected 13 with hyperprolactinaemia and a prolactinoma, and divided them into two groups on the basis of the predominant PRL isoform, the large PRL group (five patients), with a predominance of the big big PRL isoform, and the monomeric PRL (mPRL) group (eight patients), with a predominance of the mPRL isoform. Plasma PRL concentrations were measured by radioimmunoassay, while plasma PRL heterogeneity was studied by gel filtration chromatography. The plasma autoantibody-bound PRL and the histology of the tumours were also studied. RESULTS: Macroprolactinaemia was seen in five out of the 13 patients with a PRL adenoma. The clinical and biological characteristics of the groups with and without macroprolactinaemia were similar. In the large PRL group, no evidence for anti-PRL autoantibodies was found and the prolactinomas were either typical or exhibited unusual aggregates of immunoreactive PRL deposits, the latter suggesting the tumoral origin of these large forms. CONCLUSION: Our results suggest that PRL adenoma may be associated with macroprolactinaemia.
Key words: hyperprolactinaemia/macroprolactinaemia/pituitary tumours/prolactinomas
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