Macroprolactinemia in Patients Presenting with Hyperandrogenic Symptoms and Hyperprolactinemia

Macroprolactinemia may account for a signifi-cant number of hyperprolactinemic sera includ-ing hyperandrogenemic women and this may lead to unnecessary diagnostic and therapeutic procedures and false exclusion of PCOS. The aim of this study was to evaluate macroprolactinemia in women with hyperandrogenemic symptoms and hyperprola-ctinemia. Materials and Methods: In a series of 200 hyper-androgenemic women aged 14-40 year, present-ing to the endocrine clinic of Ghaem Hospital between 2004-2006, serum prolactin was meas-ured. Those with hyperprolactinemia (prolactin >35μg/L), were studied for the presence of ma-croprolactinemia using the by polyethylenegly-col precipitation test (PEG). Results: Mean age of hyperandrogenic women was 24.0±5.6 years; 38 (19%) of the patients had serum prolactin >30 µg/L and in 9 of them the rise was >35 µg/L. Macroprolactinemia was de-tected in 5 of those with serum prolactin >35 µg/L who also carried the diagnosis of PCOS. In the remaining 4 patients there was true hyper-prolactinemia and prolactin remained elevated after PEG precipitation test (52±10, vs 48±9 µg/L, respectively). Conclusion: It is necessary to rule out macropr-olactinemia in women presenting with hyperan-drogenemic symptoms and hyperprolactinemia to prevent false exclusion of PCOS. This may help to avoid expensive and unnecessary diag-nostic procedures and inappropriate use of do-paminergic agonists.