Original Articles: Hormones and Reproductive Health
Persistence of Macroprolactinemia Due to Antiprolactin Autoantibody before, during, and after Pregnancy in a Woman with Systemic Lupus Erythematosus
Alfredo Leaños-Miranda,
Dalila Pascoe-Lira,
Karina A. Chávez-Rueda and
Francisco Blanco-Favela
Laboratory of Autoimmunity, Immunology Research Unit, Hospital de
Pediatría, Centro Médico Nacional Siglo XXI, Instituto
Mexicano del Seguro Social, México City, 06725
México
Address correspondence and requests for reprints to: Dr. Alfredo Leaños-Miranda, M.D., Ph.D., Laboratory of Autoimmunity, Immunology Research Unit, Hospital de Pediatría, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Av. Cuauhtémoc 330, Col. Doctores, 06725 México, D.F., México. E-mail: alfredo{at}intranet.com.mx
Abstract
A woman with systemic lupus erythematosus (SLE) with markedincreases
in circulating 150-kDa PRL was studied from beforeconception,
throughout pregnancy, and after pregnancy. The clinicalfeatures of the
patient included idiopathic hyperprolactinemiawithout clinical
symptoms such as amenorrhea and galactorrheabefore pregnancy. No
clinical lupus activity was present duringfollow-up. Serum PRL
increase during pregnancy in this patientwas considerably higher at
weeks 27 and 33 than in normal pregnantwomen. In contrast, serum-free
PRL levels were considerablylower at weeks 20, 27, and 33 than in
normal pregnant women.A 150-kDa PRL (big big PRL) species persisted as
the predominantcirculating form of PRL throughout each measurement in
thiswoman with SLE. In contrast, the predominant form of PRL inserum
from healthy pregnant women was little PRL (or monomericPRL). The
nature of big big PRL was due to the presence of anti-PRL
autoantibodiesforming an IgG-23 kDa PRL complex, in accordance with
the studiesby affinity chromatography for IgG and Western blot
analysis.The IgG-PRL complex was fully bioactive in
vitro (Nb2 rat lymphomacell assay). Injection of the serum
into the rats demonstratedthat the IgG-PRL complex was cleared more
slowly than serumcontaining predominantly monomeric PRL. The data
suggest thatthe IgG-PRL complex has biological activity; the absence
ofsymptoms in this woman may be attributed to the fact that dueto its
large molecular weight, big big PRL does not easily crossthe capillary
walls. Delayed clearance may account for increasedserum PRL levels in
this SLE patient with anti-PRL autoantibodies.
This article has been cited by other articles:
A. Leanos-Miranda, J. Marquez-Acosta, G. M. Cardenas-Mondragon, Z. L. Chinolla-Arellano, R. Rivera-Leanos, S. Bermejo-Huerta, J. F. Romero-Arauz, G. Alvarez-Jimenez, J. C. Ramos-Leon, and A. Ulloa-Aguirre Urinary Prolactin as a Reliable Marker for Preeclampsia, Its Severity, and the Occurrence of Adverse Pregnancy Outcomes
J. Clin. Endocrinol. Metab.,
July 1, 2008;
93(7):
2492 - 2499.
[Abstract][Full Text][PDF]
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]
A. Glezer, C. R. J. Soares, J. G. Vieira, D. Giannella-Neto, M. T. C. P. Ribela, V. Goffin, and M. D. Bronstein Human Macroprolactin Displays Low Biological Activity via Its Homologous Receptor in a New Sensitive Bioassay
J. Clin. Endocrinol. Metab.,
March 1, 2006;
91(3):
1048 - 1055.
[Abstract][Full Text][PDF]
A. Leanos-Miranda and G. Cardenas-Mondragon Serum free prolactin concentrations in patients with systemic lupus erythematosus are associated with lupus activity
Rheumatology,
January 1, 2006;
45(1):
97 - 101.
[Abstract][Full Text][PDF]
F Blanco-Favela, K Chavez-Rueda, and A Leanos-Miranda Analysis of anti-prolactin autoantibodies in systemic lupus erythematosus
Lupus,
October 1, 2001;
10(10):
757 - 761.
[Abstract][PDF]
