Specificity and clinical utility of methods for the detection of macroprolactin.
Clin Chem
; 52(7): 1366-72, 2006 Jul.
Article
em En
| MEDLINE
| ID: mdl-16675508
ABSTRACT
BACKGROUND:
Increased serum concentrations of macroprolactin are a relatively common cause of misdiagnosis and mismanagement of hyperprolactinemic patients.METHODS:
We studied sera from a cohort of 42 patients whose biochemical hyperprolactinemia was explained entirely by macroprolactin. Using 5 pretreatments, polyethylene glycol (PEG), protein A (PA), protein G (PG), anti-human IgG (anti-hIgG), and ultrafiltration (UF), to deplete macroprolactin from sera before immunoassay, we compared residual prolactin concentrations with monomer concentrations obtained by gel-filtration chromatography (GFC). A monomeric prolactin standard was used to assess recovery and specificity of the pretreatment procedures.RESULTS:
Residual prolactin concentrations in all pretreated sera differed significantly (P < 0.001) from monomeric concentrations obtained after GFC. PEG underestimated (mean, 75%), whereas PA, PG, anti-hIgG, and UF overestimated (means, 178%, 151%, 178%, and 112%, respectively) the amount of monomer present. Of the 5 methods examined, PEG correlated best with GFC (r = 0.80) followed by PG (r = 0.78), PA (r = 0.72), anti-hIgG (r = 0.70), and UF (r = 0.61). After UF or pretreatment with anti-hIgG or PEG, recovery of monomeric prolactin standard was low 60%, 85%, and 77% respectively. In contrast, pretreatment with PA or PG gave almost quantitative recovery.CONCLUSIONS:
None of the methods examined yielded results identical to the GFC method. PEG pretreatment yielded results that correlated best and is recommended as the first-choice alternative to GFC.
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Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Prolactina
Tipo de estudo:
Diagnostic_studies
/
Health_economic_evaluation
Limite:
Humans
Idioma:
En
Ano de publicação:
2006
Tipo de documento:
Article