The Turkish Journal of Pediatrics 2006 , Vol 48 , Num 2
Macroprolactinemia in childhood and adolescence: a cause of hyperprolactinemia
1Pediatric Endocrinology Unit, Department of Pediatrics, İstanbul University İstanbul Faculty of Medicine, İstanbul, Turkey
2Ministry of Health, Sait Çiftçi Outpatient Clinic, İstanbul, Turkey
3Dr. Pakize İ. Tarzi Laboratory, İstanbul, Turkey
Tütüncüler F, Darendeliler F, Aygün M, Hekim N. Macroprolactinemia in childhood and adolescence: a cause of hyperprolactinemia. Turk J Pediatr 2006; 48: 143-147.

Human prolactin consists of multiple forms of different sizes including three major prolactin (PRL) species, termed as little, big, and big-big PRL. If serum contains big-big PRL, it is termed macroprolactinemia; no symptoms of hyperprolactinemia develop due to low biological activity of big-big PRL. There are still few data regarding macroprolactinemia in children and adolescents. In this paper we describe six patients with macroprolactinemia, one of whom was asymptomatic and the other five either had headache, menstrual disturbance, short stature, increased hair growth or early puberty, compatible with high PRL levels. Two of the cases had microadenoma. Initial mean±SD PRL levels of the patients were 75.2±22.8 ng/ml (range: 42.3-105.2 ng/ml). Macroprolactin analysis revealed big-big PRL levels of the patients ranging between 21.6-98.6 ng/ml. It was noteworthy that bromocriptine (BRC) therapy started in three patients caused an abrupt decrease in PRL levels. It may be concluded that macroprolactinemia should be taken into account in the differential diagnosis of hyperprolactinemia in childhood and adolescence, whether or not they have relevant clinical symptoms. Keywords : prolactin, macroprolactinemia, hyperprolactinemia, childhood, adolescent

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