Journal of Clinical Endocrinology & Metabolism, Vol 81, 586-590, Copyright © 1996 by Endocrine Society

ARTICLES

The frequency of macroprolactinemia in pregnant women and the heterogeneity of its etiologies

N Hattori
Department of Pharmacology, Kansai Medical University, Osaka, Japan.

We surveyed pregnant women for macroprolactinemia and examined the heterogeneity of its etiologies. Serum samples obtained from 105 pregnant women (29.7 +/- 4.4 yr) during the third trimester were treated with polyethylene glycol, and 3 women (2.9%) were found to have a significantly high proportion of precipitated prolactin (PRL). Gel filtration studies revealed that big-big PRL (molecular weight greater than 100,000) was predominant (63.6, 74.0, 43.5% vs. 0.3 +/- 0.2% in normal pregnant women). The common clinical features of the 3 women included idiopathic hyperprolactinemia without any clinical symptoms such as amenorrhea and galactorrhea before pregnancy and very high levels of PRL (1680, 793, and 790 micrograms/L vs. 315 +/- 112 micrograms/L in normal pregnant women) during pregnancy. However, the nature of big-big PRL was different. Two of the 3 women possessed anti- PRL autoantibody (125I-PRL binding to the serum: 17.6%, 18.6% vs. 6.9 +/- 1.6% in normal pregnant women), but the other one did not have it. A significantly high proportion of PRL was absorbed to a concanavalin A column (41.1% vs. 4.0 +/- 2.1% in normal pregnant women), repetitive freezing and thawing of isolated big-big PRL resulted in a partial conversion to big and little PRL, and reduction of the isolated big-big PRL with 2-mercaptoethanol almost completely converted big-big PRL to little PRL in this woman. These findings suggest that this woman had a heterogeneous complex of covalently and noncovalently bound form of PRL with increased glycosylation. We conclude that macroprolactinemia is present with considerable frequency in pregnant women and that different etiologies are involved to form big-big PRL in macroprolactinemia.

This article has been cited by other articles:

				A. Leanos-Miranda, G. Cardenas-Mondragon, A. Ulloa-Aguirre, I. Isordia-Salas, A. Parra, and J. Ramirez-Peredo Anti-prolactin autoantibodies in pregnant women with systemic lupus erythematosus: maternal and fetal outcome Lupus, May 1, 2007; 16(5): 342 - 349. [Abstract] [PDF]

				N. Hattori, Y. Nakayama, K. Kitagawa, T. Li, and C. Inagaki Development of Anti-PRL (Prolactin) Autoantibodies by Homologous PRL in Rats: A Model for Macroprolactinemia Endocrinology, May 1, 2007; 148(5): 2465 - 2470. [Abstract] [Full Text] [PDF]

				N Hattori, Y Nakayama, K Kitagawa, T Ishihara, Y Saiki, and C Inagaki Anti-prolactin (PRL) autoantibody-binding sites (epitopes) on PRL molecule in macroprolactinemia. J. Endocrinol., August 1, 2006; 190(2): 287 - 293. [Abstract] [Full Text] [PDF]

				J. Schiettecatte, A. Van Opdenbosch, E. Anckaert, J. De Schepper, K. Poppe, B. Velkeniers, and J. Smitz Immunoprecipitation for Rapid Detection of Macroprolactin in the Form of Prolactin-Immunoglobulin Complexes Clin. Chem., September 1, 2005; 51(9): 1746 - 1748. [Full Text] [PDF]

				J. Gibney, T. P. Smith, and T. J. McKenna The Impact on Clinical Practice of Routine Screening for Macroprolactin J. Clin. Endocrinol. Metab., July 1, 2005; 90(7): 3927 - 3932. [Abstract] [Full Text] [PDF]

				N. Hattori, K. Ikekubo, Y. Nakaya, K. Kitagawa, and C. Inagaki Immunoglobulin G Subclasses and Prolactin (PRL) Isoforms in Macroprolactinemia Due to Anti-PRL Autoantibodies J. Clin. Endocrinol. Metab., May 1, 2005; 90(5): 3036 - 3044. [Abstract] [Full Text] [PDF]

				M. Fahie-Wilson In Hyperprolactinemia, Testing for Macroprolactin Is Essential Clin. Chem., September 1, 2003; 49(9): 1434 - 1436. [Full Text] [PDF]

				C. Mounier, J. Trouillas, B. Claustrat, R. Duthel, and B. Estour Macroprolactinaemia associated with prolactin adenoma Hum. Reprod., April 1, 2003; 18(4): 853 - 857. [Abstract] [Full Text] [PDF]

				R. Sapin and G. Kertesz Macroprolactin Detection by Precipitation with Protein A-Sepharose: A Rapid Screening Method Compared with Polyethylene Glycol Precipitation Clin. Chem., March 1, 2003; 49(3): 502 - 505. [Full Text] [PDF]

				S. Vallette-Kasic, I. Morange-Ramos, A. Selim, G. Gunz, S. Morange, A. Enjalbert, P.-M. Martin, P. Jaquet, and T. Brue Macroprolactinemia Revisited: A Study on 106 Patients J. Clin. Endocrinol. Metab., February 1, 2002; 87(2): 581 - 588. [Abstract] [Full Text] [PDF]

				A. Leanos-Miranda, D. Pascoe-Lira, K. A. Chavez-Rueda, and F. Blanco-Favela Persistence of Macroprolactinemia Due to Antiprolactin Autoantibody before, during, and after Pregnancy in a Woman with Systemic Lupus Erythematosus J. Clin. Endocrinol. Metab., June 1, 2001; 86(6): 2619 - 2624. [Abstract] [Full Text] [PDF]

				H. Leslie, C. H. Courtney, P. M. Bell, D. R. Hadden, D. R. McCance, P. K. Ellis, B. Sheridan, and A. B. Atkinson Laboratory and Clinical Experience in 55 Patients with Macroprolactinemia Identified by a Simple Polyethylene Glycol Precipitation Method J. Clin. Endocrinol. Metab., June 1, 2001; 86(6): 2743 - 2746. [Abstract] [Full Text] [PDF]

				D. Pascoe-Lira, G. Duran-Reyes, I. Contreras-Hernández, L. Manuel-Apolinar, F. Blanco-Favela, and A. Leaños-Miranda Frequency of Macroprolactinemia Due to Autoantibodies against Prolactin in Pregnant Women J. Clin. Endocrinol. Metab., February 1, 2001; 86(2): 924 - 929. [Abstract] [Full Text]

				M. J. Diver, D. L. Ewins, R. C. Worth, S. Bowles, J. A. Ahlquist, and M. N. Fahie-Wilson An Unusual Form of Big, Big (Macro) Prolactin in a Pregnant Patient Clin. Chem., February 1, 2001; 47(2): 346 - 348. [Full Text] [PDF]

				M. N. Fahie-Wilson and R. John Detection of Macroprolactin Causing Hyperprolactinemia in Commercial Assays for Prolactin Dr. John responds: Clin. Chem., December 1, 2000; 46(12): 2022 - 2023. [Full Text] [PDF]

				N. Hattori and C. Inagaki Anti-Prolactin (PRL) Autoantibodies Cause Asymptomatic Hyperprolactinemia: Bioassay and Clearance Studies of PRL-Immunoglobulin G Complex J. Clin. Endocrinol. Metab., September 1, 1997; 82(9): 3107 - 3110. [Abstract] [Full Text] [PDF]