Macroprolactin: From laboratory to clinical practice

May 6, 2021

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Publicated to: Endocrinologia Diabetes Y Nutricion. 69 (1): 63-69 - 2022-01-01 69(1), DOI: 10.1016/j.endinu.2020.12.002

Authors:

Biagetti, Betina; Ferrer Costa, Roser; Alfayate Guerra, Rocio; Alvarez Garcia, Elias; Berlanga Escalera, Eugenio; Casals, Gregori; Esteban Salan, Margarita; Granada Ibern, Maria-Luisa; Gorrin Ramos, Jorge; Lopez Lazareno, Nieves; Oriola, Josep; Sanchez Martinez, Pilar Maria; Torregrosa Quesada, M Eugenia; Urgell Rull, Eulalia; Garcia Lacalle, Concepcion

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Affiliations

CHU Vigo, Serv Anal Clin, Hosp Meixoeiro, Vigo, Pontevedra, Spain - Author

Hosp Clin Univ, Serv Bioquim & Genet Mol, IDIBAPS, Barcelona, Spain - Author

Hosp Gen Univ Alicante, Lab Anal Clin, Alicante, Spain - Author

Hosp Gen Univ Alicante, Serv Anal Clin, Lab Hormonas, Alicante, Spain - Author

Hosp Gen Univ Gregorio Maranon, Serv Boquim, Lab Hormonas & Biomarcadores, Madrid, Spain - Author

Hosp Santa Creu & Sant Pau, Serv Bioquim, Barcelona, Spain - Author

Hosp Univ Cruces, Lab Bioquim, Baracaldo, Vizcaya, Spain - Author

Hosp Univ Sabadell, Lab Parc Tauli, Barcelona, Spain - Author

Hosp Univ Severo Ochoa, Serv Anal Clin, Madrid, Spain - Author

Hosp Univ Virgen Macarena, Unidad Gest Clin Bioquim Clin, Seville, Spain - Author

Univ Autonoma Barcelona, Hosp Univ Germans Trias I Pujol, Serv Bioquim Clin, Barcelona, Spain - Author

Univ Autonoma Barcelona, Hosp Univ Vall dHebron, Serv Bioquim, Lab Clin, Barcelona, Spain - Author

Univ Autonoma Barcelona, Hosp Univ Vall dHebron, Serv Endocrinol & Nutr, Barcelona, Spain - Author

Abstract

Prolactin measurement is very common in standard clinical practice. It is indicated not only in the study of pituitary adenomas, but also when there are problems with fertility, decreased libido, or menstrual disorders, among other problems. Inadequate interpretation of prolactin levels without contextualizing the laboratory results with the clinical, pharmacological, and gynecological/urological history of patients leads to erroneous diagnoses and, thus, to poorly based studies and treatments. Macroprolactinemia, defined as hyperprolactinemia due to excess macroprolactin (an isoform of a greater molecular weight than prolactin but with less biological activity), is one of the main causes of such erroneous diagnoses, resulting in poor patient management when not recognized. There is no unanimous agreement as to when macroprolactin screening is required in patients with hyperprolactinemia. At some institutions, macroprolactin testing by polyethylene glycol (PEG) precipitation is routinely performed in all patients with hyperprolactinemia, while others use a clinically based approach. There is also no consensus on how to express the results of prolactin/macroprolactin levels after PEG, which in some cases may lead to an erroneous interpretation of the results. The objectives of this study were: 1. To establish the strategy for macroprolactin screening by serum precipitation with PEG in patients with hyperprolactinemia: universal screening versus a strategy guided by the alert generated by the clinician based on the absence or presence of clinical symptoms or by the laboratory when hyperprolactinemia is detected. 2. To create a consensus document that standardizes the reporting of prolactin results after precipitation with PEG to minimize errors in the interpretation of the results, in line with international standards.Copyright © 2021 SEEN y SED. Publicado por Elsevier España, S.L.U. All rights reserved.

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Keywords

big prolactindiagnosishyperprolactinemiamonomeric prolactinpolyethylene glycolprecipitationprolactinreference intervalsBig prolactinGran prolactinaMacroprolactinMacroprolactinaPolietilenglicolPolyethylene glycolPolyethylene-glycolProlactinProlactina

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Bibliometric impact. Analysis of the contribution and dissemination channel

The work has been published in the journal Endocrinologia Diabetes y Nutricion, and although the journal is classified in the quartile Q4 (Agencia WoS (JCR)), its regional focus and specialization in Nutrition & Dietetics, give it significant recognition in a specific niche of scientific knowledge at an international level.

From a relative perspective, and based on the normalized impact indicator calculated from World Citations provided by WoS (ESI, Clarivate), it yields a value for the citation normalization relative to the expected citation rate of: 1.3. This indicates that, compared to works in the same discipline and in the same year of publication, it ranks as a work cited above average. (source consulted: ESI Nov 13, 2025)

Specifically, and according to different indexing agencies, this work has accumulated citations as of 2026-04-06, the following number of citations:

WoS: 14
Scopus: 10

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