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Prevalence and re-evaluation of macroprolactinemia in hyperprolactinemic patients: a retrospective study in the Turkish population

  • Osman Oğuz ORCID logo EMAIL logo , Kerim Erhan Palaoğlu ORCID logo and Said Incir ORCID logo
Published/Copyright: April 7, 2025
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Clinical Chemistry and Laboratory Medicine (CCLM)
From the journal Clinical Chemistry and Laboratory Medicine (CCLM) Volume 63 Issue 9

Abstract

Objectives

This study aimed to investigate the prevalence of macroprolactinemia and the changes in hyperprolactinemia status over time among hyperprolactinemic patients in the Turkish population.

Methods

A retrospective study was conducted on 3,013 patient records from a central university hospital between October 2023 and October 2024. Of these, 634 hyperprolactinemic samples (Prolactin >15.2 μg/L in males, >23.3 μg/L in females) were analyzed using polyethylene glycol (PEG) precipitation method. Post-PEG prolactin levels were measured using electrochemiluminescence immunoassay, with the recovery percentage (R%) calculated as the ratio of prolactin post-PEG precipitation to total prolactin, where R% values below 40 % were indicative of macroprolactinemia. The change in R% values was analyzed in 63 hyperprolactinemic patients who underwent restesting.

Results

Macroprolactinemia prevalence was found as 5.67 % of hyperprolactinemic patients with no macroprolactinemia cases observed at PRL levels above 85.40 μg/L. Male patients had significantly higher R% values than females (p=0.003). In the gray zone (R%: 40–60), 29.03 % of patients were classified as truly hyperprolactinemic. Repeated tests after an average of four months showed stable R% values in most cases, with only two patients changing classification between macroprolactinemia and true hyperprolactinemia.

Conclusions

The prevalence of macroprolactinemia in hyperprolactinemic Turkish patients was relatively low. As prolactin values increase, true hyperprolactinemia is more commenly observed instead of macroprolactinemia. Short-term retesting for macroprolactinemia may not be necessary unless clinical conditions change significantly. Accurate diagnosis requires method-specific cutoffs and further prospective studies using gold-standard methods like gel filtration chromatography.

Keywords: big prolactin; hyperprolactinemia; immunoassay interference; macroprolactin polyethylene glycol (PEG)
Corresponding author: Osman Oğuz, Associate Professor, Clinical Laboratory, VKV American Hospital, Güzelbahçe Street, Istanbul, P.C: 34365, Türkiye, E-mail:

  1. Research ethics: 2025.076.IRB1.13 Osman OğuzTürk Toplumunda Makroprolaktinemi Yaygınlığı ve Tanısal Algoritması. Approved by Koç University Ethics Committee.

  2. Informed consent: Not applicable.

  3. Author contributions: Osman Oğuz: Concept + data collection and analyses + writing. Kerim Erhan Palaoğlu: Concept + design. Said İncir: Concept + data analyses + literature review. All authors have accepted responsibility for the entire content of this manuscript and approved its submission.

  4. Use of Large Language Models, AI and Machine Learning Tools: None declared.

  5. Conflict of interest: The authors state no conflict of interest.

  6. Research funding: None declared.

  7. Data availability: Available. Access can be provided if desired.

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Received: 2025-02-14
Accepted: 2025-03-26
Published Online: 2025-04-07
Published in Print: 2025-08-26

© 2025 Walter de Gruyter GmbH, Berlin/Boston

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  1. Frontmatter
  2. Editorial
  3. Macroprolactinaemia – some progress but still an ongoing problem
  4. Review
  5. Understanding the circulating forms of cardiac troponin: insights for clinical practice
  6. Opinion Papers
  7. New insights in preanalytical quality
  8. IFCC recommendations for internal quality control practice: a missed opportunity
  9. Genetics and Molecular Diagnostics
  10. Evaluation of error detection and treatment recommendations in nucleic acid test reports using ChatGPT models
  11. General Clinical Chemistry and Laboratory Medicine
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  13. Improving the efficiency of quality control in clinical laboratory with an integrated PBRTQC system based on patient risk
  14. IgA-type macroprolactin among 130 patients with macroprolactinemia
  15. Prevalence and re-evaluation of macroprolactinemia in hyperprolactinemic patients: a retrospective study in the Turkish population
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  24. Potential coeliac disease in children: a single-center experience
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  27. Development of commutable candidate certified reference materials from protein solutions: concept and application to human insulin
  28. Reference Values and Biological Variations
  29. Biological variation of serum cholinesterase activity in healthy subjects
  30. Hematology and Coagulation
  31. Diagnostic performance of morphological analysis and red blood cell parameter-based algorithms in the routine laboratory screening of heterozygous haemoglobinopathies
  32. Cancer Diagnostics
  33. Promising protein biomarkers for early gastric cancer: clinical performance of combined detection
  34. Infectious Diseases
  35. The accuracy of presepsin in diagnosing neonatal late-onset sepsis in critically ill neonates: a prospective study
  36. Corrigendum
  37. The Unholy Grail of cancer screening: or is it just about the Benjamins?
  38. Letters to the Editor
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https://doi.org/10.1515/cclm-2025-0177
Keywords for this article
big prolactin; hyperprolactinemia; immunoassay interference; macroprolactin polyethylene glycol (PEG)

Articles in the same Issue

  1. Frontmatter
  2. Editorial
  3. Macroprolactinaemia – some progress but still an ongoing problem
  4. Review
  5. Understanding the circulating forms of cardiac troponin: insights for clinical practice
  6. Opinion Papers
  7. New insights in preanalytical quality
  8. IFCC recommendations for internal quality control practice: a missed opportunity
  9. Genetics and Molecular Diagnostics
  10. Evaluation of error detection and treatment recommendations in nucleic acid test reports using ChatGPT models
  11. General Clinical Chemistry and Laboratory Medicine
  12. Pre-analytical phase errors constitute the vast majority of errors in clinical laboratory testing
  13. Improving the efficiency of quality control in clinical laboratory with an integrated PBRTQC system based on patient risk
  14. IgA-type macroprolactin among 130 patients with macroprolactinemia
  15. Prevalence and re-evaluation of macroprolactinemia in hyperprolactinemic patients: a retrospective study in the Turkish population
  16. Defining dried blood spot diameter: implications for measurement and specimen rejection rates
  17. Screening primary aldosteronism by plasma aldosterone-to-angiotensin II ratio
  18. Assessment of serum free light chain measurements in a large Chinese chronic kidney disease cohort: a multicenter real-world study
  19. Beyond the Hydrashift assay: the utility of isoelectric focusing for therapeutic antibody and paraprotein detection
  20. Direct screening and quantification of monoclonal immunoglobulins in serum using MALDI-TOF mass spectrometry without antibody enrichment
  21. Effect of long-term frozen storage on stability of kappa free light chain index
  22. Impact of renal function impairment on kappa free light chain index
  23. Standardization challenges in antipsychotic drug monitoring: insights from a national survey in Chinese TDM practices
  24. Potential coeliac disease in children: a single-center experience
  25. Vitamin D metabolome in preterm infants: insights into postnatal metabolism
  26. Candidate Reference Measurement Procedures and Materials
  27. Development of commutable candidate certified reference materials from protein solutions: concept and application to human insulin
  28. Reference Values and Biological Variations
  29. Biological variation of serum cholinesterase activity in healthy subjects
  30. Hematology and Coagulation
  31. Diagnostic performance of morphological analysis and red blood cell parameter-based algorithms in the routine laboratory screening of heterozygous haemoglobinopathies
  32. Cancer Diagnostics
  33. Promising protein biomarkers for early gastric cancer: clinical performance of combined detection
  34. Infectious Diseases
  35. The accuracy of presepsin in diagnosing neonatal late-onset sepsis in critically ill neonates: a prospective study
  36. Corrigendum
  37. The Unholy Grail of cancer screening: or is it just about the Benjamins?
  38. Letters to the Editor
  39. Analytical validation of hemolysis detection on GEM Premier 7000
  40. Reconciling reference ranges and clinical decision limits: the case of thyroid stimulating hormone
  41. Contradictory definitions give rise to demands for a right to unambiguous definitions
  42. Biomarkers to measure the need and the effectiveness of therapeutic supplementation: a critical issue
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