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Clinical Chemistry 46: 1993-1995, 2000;
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(Clinical Chemistry. 2000;46:1993-1995.)
© 2000 American Association for Clinical Chemistry, Inc.

Technical Briefs

Macroprolactin and the Roche Elecsys Prolactin Assay: Characteristics of the Reaction and Detection by Precipitation with Polyethylene Glycol

Michael Fahie-Wilson1,a, Penelope Brunsden1, John Surrey2 and Anthony Everitt2

1 Department of Clinical Chemistry, Southend Hospital, Prittlewell Chase, Westcliff-on-Sea, Essex SSO ORY, United Kingdom

2 Department of Clinical Chemistry, Basildon Hospital, Nether Mayne, Basildon, Essex SS16 5NL, United Kingdom
a author for correspondence: fax 44-1702-221059, e-mail mike.fahie-wilson@hospital.southend.nhs.uk

Prolactin occasionally is present in serum in a macromolecular complex. The most common form is macroprolactin, an antibody-antigen complex of prolactin (PRL) and immunoglobulin G with a molecular mass of 150–170 kDa (1)(2)(3)(4). The PRL component remains reactive (to various degrees) in immunoassays for PRL (5)(6)(7), and macroprolactin is cleared more slowly than PRL from the circulation, leading to apparent hyperprolactinemia (8).

Macroprolactin is bioactive in vitro but has minimal bioactivity in vivo, probably because of the failure of the high-molecular mass complex to cross the capillary membrane to reach target PRL receptors (9). Hyperprolactinemia attributable to macroprolactin may cause diagnostic confusion and lead to inappropriate treatment, and it is important that laboratories characterize the response of their assay to macroprolactin and identify macroprolactin when this is a cause of hyperprolactinemia (1)(5).

The Wallac Delfia immunofluorometric PRL assay reacts strongly with macroprolactin, and this response is well characterized (5)(6)(10)(11). High concentrations of polyethylene glycol (PEG) precipitate macroprolactin from serum, and this principle has been used in a screening test for the presence of macroprolactin validated with the Delfia assay (5).

. . . [Full Text of this Article]


Acknowledgments


References




The following articles in journals at HighWire Press have cited this article:


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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
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R. Sapin and G. Kertesz
Macroprolactin Detection by Precipitation with Protein A-Sepharose: A Rapid Screening Method Compared with Polyethylene Glycol Precipitation
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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.
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R. Sapin and C. Simon
False Hyperprolactinemia Corrected by the Use of Heterophilic Antibody-blocking Agent
Clin. Chem., December 1, 2001; 47(12): 2184 - 2185.
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