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Prevalence and reproductive manifestations of macroprolactinemia

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Abstract

Purpose

Macroprolactinemia is characterized by predominance of macroprolactin molecules in circulation and generally has extra-pituitary origin. Macroprolactin is viewed as biologically inactive, therefore asymptomatic, and thus may not require any treatment or prolonged follow-up. In addition, data on prevalence of macroprolactinemia and its clinical manifestation are also rare. Therefore, the present study was aimed to find out prevalence of macroprolactinemia and its association, if any, with reproductive manifestations.

Material and methods

Macroprolactin was measured in 102 hyperprolactinemia cases (>100 ng/ml prolactin level), 135 physiological hyperprolactinemia cases (50 pregnant and 85 lactating females; >100 ng/ml prolactin level) and 24 controls. Poly ethylene glycol (PEG) precipitation method was carried out to screen macroprolactin. Prolactin recovery of <25% was considered overt macroprolactinemia. Detailed clinical data was recorded which included complete medical history, physical examination and hormone measurements besides CT/MRI for pituitary abnormalities.

Results

Prevalence of macroprolactinemia was 21.57% (22/102) in hyperprolactinemia (prolactin >100 ng/ml). There was no case of macroprolactinemia in physiological hyperprolactinemia, or healthy control females. Reproductive manifestations were present in 72.73% (16/22) macroprolactinemia cases, out of which macroprolactinemia was the sole cause of associated reproductive manifestations in 68.7% (11/16) cases. Reversal of reproductive dysfunction/s was observed in five cases with appropriate treatment for high macroprolactin.

Conclusion

Macroprolactinemia prevalence was found to be 21.5%, out of which 72.73% cases had associated reproductive dysfunctions.

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Acknowledgements

We thank Department of Obstetrics and Gynecology, All India Institute of Medical Sciences, New Delhi, India for providing their support in recruiting pregnant and lactating females for the study. We are grateful to our patients for their invaluable cooperation during the study.

Funding

This research did not receive any specific grant from any funding agency in the public, commercial or not-for-profit sector. The PhD student was receiving CSIR-UGC JRF.

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Authors and Affiliations

  1. Department of Reproductive Biology, All India Institute of Medical Sciences, New Delhi, India

    Amanpreet Kaur Kalsi, Ashutosh Halder, Manish Jain & P. K. Chaturvedi

  2. Department of Obstetrics and Gynecology, All India Institute of Medical Sciences, New Delhi, India

    J. B. Sharma

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  1. Amanpreet Kaur Kalsi
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Correspondence to Amanpreet Kaur Kalsi or Ashutosh Halder.

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All procedures performed in the study involving human participants were in accordance with the ethical standards of the institutional ethical committee.

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Informed consent was obtained from all individual participants included in the study.

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Kalsi, A.K., Halder, A., Jain, M. et al. Prevalence and reproductive manifestations of macroprolactinemia. Endocrine 63, 332–340 (2019). https://doi.org/10.1007/s12020-018-1770-6

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