Macroprolactinemia in a Patient with Invasive Macroprolactinoma : A Case Report and Minireview
Joint Authors
Zacharieva, Sabina
Vasilev, Vladimir
Abadzhieva, Zdravka
Elenkova, Atanaska
Kirilov, Georgi
Genov, Nikolai
Source
Issue
Vol. 2013, Issue 2013 (31 Dec. 2013), pp.1-5, 5 p.
Publisher
Hindawi Publishing Corporation
Publication Date
2013-01-15
Country of Publication
Egypt
No. of Pages
5
Main Subjects
Abstract EN
Background.
Macroprolactin, the high-molecular prolactin isoform, is considered to be an inactive in vivo product with extrapituitary origin.
Patients with macroprolactinemia are usually asymptomatic, with negative pituitary imaging.
Based on these data, most authors do not recommend treatment and long-term followup in subjects with macroprolactinemia.
However, there is evidence for overlapping clinical features among subjects with hyperprolactinemia due to monomeric or “big big” PRL isoform.
Case Presentation.
We present a 35-year-old female patient with secondary amenorrhea, mild obesity, hirsutism, headache and blurred vision.
Hormonal evaluation revealed an extreme hyperprolactinemia (PRL = 10 610 mIU/L) almost exclusively due to macroprolactin isoform (MPRL = 10 107 mIU/L; recovery after PEG precipitation 4.7%) and hypogonadotropic hypogonadism.
An invasive pituitary macroadenoma was visualized on MRI, and cabergoline therapy was initiated.
Disappearance of clinical signs and symptoms, normalization of gonadotropin levels, and restoration of regular ovulatory menstrual cycles after 1 year of treatment are arguments in favor of preserved-macroprolactin bioactivity in this case.
The significant decrease in MPRL levels and tumor volume in response to dopamine agonist therapy is suggestive for the tumoral origin of this isoform.
Conclusions.
Although macroprolactinemia is considered to be a benign condition, pituitary imaging, dopamine agonist treatment, and prolonged followup should be recommended in some particular cases.
American Psychological Association (APA)
Elenkova, Atanaska& Abadzhieva, Zdravka& Genov, Nikolai& Vasilev, Vladimir& Kirilov, Georgi& Zacharieva, Sabina. 2013. Macroprolactinemia in a Patient with Invasive Macroprolactinoma : A Case Report and Minireview. Case Reports in Endocrinology،Vol. 2013, no. 2013, pp.1-5.
https://search.emarefa.net/detail/BIM-486850
Modern Language Association (MLA)
Elenkova, Atanaska…[et al.]. Macroprolactinemia in a Patient with Invasive Macroprolactinoma : A Case Report and Minireview. Case Reports in Endocrinology No. 2013 (2013), pp.1-5.
https://search.emarefa.net/detail/BIM-486850
American Medical Association (AMA)
Elenkova, Atanaska& Abadzhieva, Zdravka& Genov, Nikolai& Vasilev, Vladimir& Kirilov, Georgi& Zacharieva, Sabina. Macroprolactinemia in a Patient with Invasive Macroprolactinoma : A Case Report and Minireview. Case Reports in Endocrinology. 2013. Vol. 2013, no. 2013, pp.1-5.
https://search.emarefa.net/detail/BIM-486850
Data Type
Journal Articles
Language
English
Notes
Includes bibliographical references
Record ID
BIM-486850