Extensive Experience and Validation of Polyethylene Glycol Precipitation as a Screening Method for Macroprolactinemia

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Abstract
Serum human prolactin (PRL) is heterogeneous in molecular size, with the 23-kDa monomer being the predominant form in healthy subjects and patients with prolactinomas. From the point of view of molecular size, other circulating forms include the 50-kDa dimer (big-PRL) and the 150- to 170-kDa form (big-big-PRL, or macroprolactin) ( 1). Recent publications have associated asymptomatic hyperprolactinemia with a predominance of macroprolactin in the circulation; this occurrence appears to be more common than previously thought ( 2)( 3)( 4) and can have obvious practical implications. The finding of a predominance of macroprolactinemia can change the focus of the evaluation of a patient, with the possible avoidance of more sophisticated and expensive imaging studies.

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