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Reporting of hyperprolactinaemia post-polyethylene glycol (PEG) precipitation at Hospital Tengku Ampuan Rahimah Klang, Malaysia

Introduction: Macroprolactinaemia is defined as hyperprolactinaemia due to excess macroprolactin in the presence of normal monomeric prolactin. Failure to identify macroprolactinaemia may result in patients being subjected to unnecessary investigations and inappropriate treatment for hyperprolactina...

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Main Authors: Zaharudin, Mohd Radzli, Samsudin, Intan Nureslyna, Abdul Hamid, Hanisah, C. Thambiah, Subashini
Format: Article
Published: Universiti Putra Malaysia 2024
Online Access:http://psasir.upm.edu.my/id/eprint/110532/
https://medic.upm.edu.my/upload/dokumen/2023122608242801_2022-0762.pdf
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spelling my.upm.eprints.1105322024-06-13T03:10:51Z http://psasir.upm.edu.my/id/eprint/110532/ Reporting of hyperprolactinaemia post-polyethylene glycol (PEG) precipitation at Hospital Tengku Ampuan Rahimah Klang, Malaysia Zaharudin, Mohd Radzli Samsudin, Intan Nureslyna Abdul Hamid, Hanisah C. Thambiah, Subashini Introduction: Macroprolactinaemia is defined as hyperprolactinaemia due to excess macroprolactin in the presence of normal monomeric prolactin. Failure to identify macroprolactinaemia may result in patients being subjected to unnecessary investigations and inappropriate treatment for hyperprolactinaemia. In our centre, screening for macroprolactinaemia is currently performed at the request of the treating physician. The study thus aimed to determine the frequency of macroprolactinaemia in samples with serum prolactin ≥700 mIU/L in Hospital Tengku Ampuan Rahimah (HTAR) and to determine the presence of true hyperprolactinaemia in these cases. Methods: A cross-sectional study among hyperprolactinaemic subjects in HTAR, using serum specimens received by the laboratory for measurement of prolactin between October 2018 and September 2019. Samples with prolactin ≥700 mIU/L were screened for macroprolactinaemia using the polyethylene glycol (PEG) precipitation technique. Macroprolactinaemia was present when the percentage recovery of prolactin post-PEG was <40%. Assay-specific post-PEG monomeric prolactin levels were also reported, with levels above the upper limit of reference intervals indicated the presence of true hyperprolactinaemia. Results: A total of 101 samples were subjected to PEG precipitation. Macroprolactinaemia was found in four (4%) samples, whilst eight (7.9%) were categorised as indeterminate (percentage recovery of 40-60%). The remaining 89 (88.1%) samples had a percentage recovery >60%, hence considered negative for macroprolactinaemia. All four samples with macroprolactinaemia also had raised monomeric prolactin levels indicating the co-existence of macroprolactinaemia in subjects with true hyperprolactinaemia. Similarly, in the indeterminate group, all eight had raised monomeric prolactin levels. Conclusion: In one-year period in HTAR, macroprolactinaemia was detected in 4% of subjects with prolactin ≥700 mIU/L, all of whom also had raised monomeric prolactin levels. The common occurrence of both macroprolactinaemia and true hyperprolactinaemia warrants the reporting of both percentage recovery and monomeric prolactin levels post-PEG. Universiti Putra Malaysia 2024 Article PeerReviewed Zaharudin, Mohd Radzli and Samsudin, Intan Nureslyna and Abdul Hamid, Hanisah and C. Thambiah, Subashini (2024) Reporting of hyperprolactinaemia post-polyethylene glycol (PEG) precipitation at Hospital Tengku Ampuan Rahimah Klang, Malaysia. Malaysian Journal of Medicine and Health Sciences, 19 (suppl.16). pp. 3-8. ISSN 1675-8544; ESSN: 2636-9346 https://medic.upm.edu.my/upload/dokumen/2023122608242801_2022-0762.pdf 10.47836/mjmhs.19.s16.2
institution Universiti Putra Malaysia
building UPM Library
collection Institutional Repository
continent Asia
country Malaysia
content_provider Universiti Putra Malaysia
content_source UPM Institutional Repository
url_provider http://psasir.upm.edu.my/
description Introduction: Macroprolactinaemia is defined as hyperprolactinaemia due to excess macroprolactin in the presence of normal monomeric prolactin. Failure to identify macroprolactinaemia may result in patients being subjected to unnecessary investigations and inappropriate treatment for hyperprolactinaemia. In our centre, screening for macroprolactinaemia is currently performed at the request of the treating physician. The study thus aimed to determine the frequency of macroprolactinaemia in samples with serum prolactin ≥700 mIU/L in Hospital Tengku Ampuan Rahimah (HTAR) and to determine the presence of true hyperprolactinaemia in these cases. Methods: A cross-sectional study among hyperprolactinaemic subjects in HTAR, using serum specimens received by the laboratory for measurement of prolactin between October 2018 and September 2019. Samples with prolactin ≥700 mIU/L were screened for macroprolactinaemia using the polyethylene glycol (PEG) precipitation technique. Macroprolactinaemia was present when the percentage recovery of prolactin post-PEG was <40%. Assay-specific post-PEG monomeric prolactin levels were also reported, with levels above the upper limit of reference intervals indicated the presence of true hyperprolactinaemia. Results: A total of 101 samples were subjected to PEG precipitation. Macroprolactinaemia was found in four (4%) samples, whilst eight (7.9%) were categorised as indeterminate (percentage recovery of 40-60%). The remaining 89 (88.1%) samples had a percentage recovery >60%, hence considered negative for macroprolactinaemia. All four samples with macroprolactinaemia also had raised monomeric prolactin levels indicating the co-existence of macroprolactinaemia in subjects with true hyperprolactinaemia. Similarly, in the indeterminate group, all eight had raised monomeric prolactin levels. Conclusion: In one-year period in HTAR, macroprolactinaemia was detected in 4% of subjects with prolactin ≥700 mIU/L, all of whom also had raised monomeric prolactin levels. The common occurrence of both macroprolactinaemia and true hyperprolactinaemia warrants the reporting of both percentage recovery and monomeric prolactin levels post-PEG.
format Article
author Zaharudin, Mohd Radzli
Samsudin, Intan Nureslyna
Abdul Hamid, Hanisah
C. Thambiah, Subashini
spellingShingle Zaharudin, Mohd Radzli
Samsudin, Intan Nureslyna
Abdul Hamid, Hanisah
C. Thambiah, Subashini
Reporting of hyperprolactinaemia post-polyethylene glycol (PEG) precipitation at Hospital Tengku Ampuan Rahimah Klang, Malaysia
author_facet Zaharudin, Mohd Radzli
Samsudin, Intan Nureslyna
Abdul Hamid, Hanisah
C. Thambiah, Subashini
author_sort Zaharudin, Mohd Radzli
title Reporting of hyperprolactinaemia post-polyethylene glycol (PEG) precipitation at Hospital Tengku Ampuan Rahimah Klang, Malaysia
title_short Reporting of hyperprolactinaemia post-polyethylene glycol (PEG) precipitation at Hospital Tengku Ampuan Rahimah Klang, Malaysia
title_full Reporting of hyperprolactinaemia post-polyethylene glycol (PEG) precipitation at Hospital Tengku Ampuan Rahimah Klang, Malaysia
title_fullStr Reporting of hyperprolactinaemia post-polyethylene glycol (PEG) precipitation at Hospital Tengku Ampuan Rahimah Klang, Malaysia
title_full_unstemmed Reporting of hyperprolactinaemia post-polyethylene glycol (PEG) precipitation at Hospital Tengku Ampuan Rahimah Klang, Malaysia
title_sort reporting of hyperprolactinaemia post-polyethylene glycol (peg) precipitation at hospital tengku ampuan rahimah klang, malaysia
publisher Universiti Putra Malaysia
publishDate 2024
url http://psasir.upm.edu.my/id/eprint/110532/
https://medic.upm.edu.my/upload/dokumen/2023122608242801_2022-0762.pdf
_version_ 1802978800352362496
score 13.211869

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