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Macroprolactin
MessageFor 12 hours before specimen collection do NOT take multivitamins or dietary supplements containing biotin (Vitamin B7), which is commonly found in hair, skin, and nail supplements and multivitamins.
Test Code
LAB10004
Alias/See Also
LAB10004
Mayo TC: MCRPL
Mayo TC: MCRPL
CPT Codes
84146X2
Includes
Total Prolactin
Unprecipitated Prolactin
Unprecipitated Prolactin
Preferred Specimen
1.0 mL Serum
Marble/Gold/Red
Marble/Gold/Red
Minimum Volume
0.6 mL Serum
Transport Temperature
Refrigerated
Specimen Stability
Refrigerated: 7 days
Reject Criteria (Eg, hemolysis? Lipemia? Thaw/Other?)
Gross hemolysis, Gross lipemia
Methodology
Total Prolactin: Electrochemiluminescent Immunoassay
Unprecipitated Prolactin: Polyethylene Glycol (PEG) Precipitation Followed by Electrochemiluminescent Immunoassay
Report Available
1-3 days
Limitations
Demonstration of the presence of macroprolactin does not exclude the possibility of concomitant presence of pituitary adenoma. Results should be interpreted in conjunction with clinical findings.
Reference Range
Prolactin, Total:
Males:
<18 years: not established
> or = 18 years: 4.0-15.2 ng/mL
Females:
<18 years: not established
> or = 18 years: 4.8-23.3 ng/mL
Prolactin, Unprecipitated:
Males:
<18 years: not established
> or = 18 years: 2.7-13.1 ng/mL
Females:
<18 years: not established
> or = 18 years: 3.4-18.5 mg/mL
When the percent of the precipitated (complexed) prolactin fraction of the total prolactin is 60% or less, the result is considered negative for macroprolactin.
Males:
<18 years: not established
> or = 18 years: 4.0-15.2 ng/mL
Females:
<18 years: not established
> or = 18 years: 4.8-23.3 ng/mL
Prolactin, Unprecipitated:
Males:
<18 years: not established
> or = 18 years: 2.7-13.1 ng/mL
Females:
<18 years: not established
> or = 18 years: 3.4-18.5 mg/mL
When the percent of the precipitated (complexed) prolactin fraction of the total prolactin is 60% or less, the result is considered negative for macroprolactin.
Clinical Significance
Prolactin is secreted by the anterior pituitary gland under negative control by dopamine, which is secreted by the hypothalamus. The only physiological function of prolactin is the stimulation of milk production. In normal individuals, the prolactin level rises in response to physiologic stimuli such as nipple stimulation, sleep, exercise, sexual intercourse, and hypoglycemia. Pathologic causes of hyperprolactinemia include prolactin-secreting pituitary adenoma (prolactinoma), diseases of the hypothalamus, primary hypothyroidism, section compression of the pituitary stalk, chest wall lesions, renal failure, and ectopic tumors.
Hyperprolactinemia may also be caused by the presence of a high-molecular–mass complex of prolactin called macroprolactin (typically due to prolactin bound to immunoglobulin). In this situation, the patient is asymptomatic. Hyperprolactinemia attributable to macroprolactin is a frequent cause of misdiagnosis and mismanagement of patients. Macroprolactin should be considered if, in the presence of elevated prolactin levels, signs and symptoms of hyperprolactinemia are absent, or pituitary imaging studies are not informative.
Hyperprolactinemia may also be caused by the presence of a high-molecular–mass complex of prolactin called macroprolactin (typically due to prolactin bound to immunoglobulin). In this situation, the patient is asymptomatic. Hyperprolactinemia attributable to macroprolactin is a frequent cause of misdiagnosis and mismanagement of patients. Macroprolactin should be considered if, in the presence of elevated prolactin levels, signs and symptoms of hyperprolactinemia are absent, or pituitary imaging studies are not informative.
Performing Laboratory
Mayo Clinic Laboratories