DOI QR코드

DOI QR Code

Prolactin Monomeric Polyethylene Glycol Measurement Method and Study of Reference Value Verification

  • Dong Hyuk Ha (Department of Nuclear Medicine, Seoul National University Hospital) ;
  • Hwa-Jin Ryu (Department of Nuclear Medicine, Seoul National University Hospital) ;
  • Hyun-Su Cho (Department of Nuclear Medicine, Seoul National University Hospital) ;
  • Sun-Young Shin (Department of Nuclear Medicine, Seoul National University Hospital)
  • Received : 2023.10.12
  • Accepted : 2023.11.02
  • Published : 2023.11.30

Abstract

Purpose: Prolactin in the blood is separated into three types, and over 90% of prolactin presents as a double monomer (23 KDa). Rarely, it can exist in the size of big prolactin (150 KDa), which is called macroprolactin and is known as an autoantibody complex. When macroprolactin accounts for more than 60% of prolactin in the blood, it is called macroprolactinemia. The presence of such macroprolactin was first reported in a patient with hyperprolactinemia but without typical symptoms. Macroprolactinemia is emerging as an important cause of idiopathic hyperprolactinemia. The polyethylene glycol (PEG) precipitation method using the property of precipitating large-molecular-weight proteins is simple and recently has been widely used as a screening test. The results are in good agreement with the results of gel chromatography. The purpose of this study was to confirm the measurement method and reference value verification of monomeric prolactin in blood prolactin using the PEG precipitation method. Materials and Methods: For 40 examinees who visited the Gangnam Center of Seoul National University Hospital in 2021, the prolactin level was verified using radioimmunoassay (RIA). For macroprolactinemia PEG precipitation method, 25% PEG (molecular weight 6000kDa) solution and serum were mixed in equal amounts in a test tube, then left at room temperature for 20 minutes and centrifuged at 4℃ for 30 minutes (1500g). The prolactin level was measured in the supernatant. Results : After confirming that more than 90% of the 40 tested samples within the reference range <25 ng/mL, the same value as the reference value for prolactin was applied. Since the concentration of monomeric prolactin in serum from which macroprolactin has been removed from blood is diluted 1:1 with PEG, our laboratory is currently reporting the result by multiplying the result by a dilution factor of 2. Conclusion: Radioimmunoassay using PEG precipitation method using the property of precipitating large molecular weight proteins is simple and effective for quantitative measurement of monomeric prolactin in blood prolactin.

Keywords

References

  1. Suh HK, Frnatz AG. Size heterogeneity of human prolactin in plasma and pituitary extracts. J Clin Endocrinol Metab 39:928-935, 1974 https://doi.org/10.1210/jcem-39-5-928
  2. Jackson RD, Wortasman J, Malarkey WB. Macroprolactinemia presenting like a pituitary tumor. Am J Med 78:346-350, 1985 https://doi.org/10.1016/0002-9343(85)90448-6
  3. Covaco B, Leite V, Santos MA, Arranhado E, Sobrinho LG. Some forms of big big prolactin behave as a acomplex of monomeric prolactin with an immunoglobulin G in patients with macroprolactinemia or prolactinoma. J Clin Endocrinol Metab 80:2342-2436.1995 https://doi.org/10.1210/jcem.80.8.7629227
  4. Whttaker PG, Wilcox T, Lin T. Maintained fertility in a patient with hyperprolactinemia due to big big prolactin. J Clin Endocrinol Metab 53:863-866,1981 https://doi.org/10.1210/jcem-53-4-863
  5. Martin TL, Kim M, Malarkey WB. The netural history of idiopathic hyperprolactinemia. J Clin Endocrinol Metab 60:855-858, 1985 https://doi.org/10.1210/jcem-60-5-855
  6. Yongjian Chen, Huan Wang, Wei Yang, Weidong Jin, Wenge Yu, Wei Wang, Kailin Z, Guangzhong Song. A New Method of Using Polyethylene Glycol Precipitation of Macroprlactin to Detect Genuine Hyperprolactinemia. Journal of Clinical Laboratory Analysis 2016;30:1169-1174 https://doi.org/10.1002/jcla.21999
  7. Choi YJ, Kang JG, Kim SY, Hong ES, Kim SW, Shin CS, Kim SY, Cho BY, Lee HK. The Clinical Characteristics of Macroprolactinemia. Endocrinology and Metabolism 20:3, 2005.
  8. G. Lippi, M. Plebani. Biology, Medicine. Clinical Chemistry and Laboratory Medicine (CCLM). DOI:10.1515/cclm-2015-1283
  9. Mok JO. Hyperprolactinemia Letter of the Korean Endocrine Society 8(1):2015. Available at: https://www.endocrinology.or.kr/webzine/201502/sub3_1.html. Accessed September 12, 2023.