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Objective:To analyze the clinical materials of the patient with Van Wyk and Grumbach syndrome (VWGS),and to explore the pathogenesis,clinical characteristics,diagnosis,differential diagnosis and treatment method.Methods:The clinical data of a patient with VWGS was analyzed retrospectively.Results:The patient presented autoimmune thyroiditis, sever long-standing hypothyroidism, bilateral ovarian cysts, hyperprolactinaemia and a secondary pituitary adenoma. After thyroxine replacement treatment, the thyroid function and prolactin (PRL)level recovered to the normal levels and the ovarian cyst was shrunk within 1 month. Conclusion:The clinical manifestation of VWGS is special.And it’s easy to misdiagnose this syndrome as pituitary adenoma or ovary cyst and then operation is performed.Thyroid hormone replacement can completely resolve the symptoms and hormone abnormalities.Grasping the clinical characteristics of this syndrome and making correct diagnosis is critical to avoid unnecessary operation.
RESUMO
Introduction: Prolactin (PRL) exists in different forms in human serum. The predominant form is monomeric PRL (molecular mass 23 kDa) with smaller amounts of big PRL (molecular mass 50–60 kDa) and at times macroprolactin (molecular mass 150–170 kDa). Macroprolactin, generally considered to be biologically inactive, accounts for the major part of prolactin in some patients. Different immunoassays for prolactin differ in reactivity with this macromolecular complex. Aim: The present study was undertaken to assess the incidence of macroprolactinaemia in our cohort of hyperprolactinemic patients. Method: 204 samples with hyperprolactinemia were evaluated for macroprolactinemia by polyethylene glycol (PEG) precipitation and gel fi ltration chromatography (GFC). Recoveries 40% but 50%. The incidence of macroprolactinemia in our cohort of hyperprolactinaemic patients was noted to be 4.4%. Conclusion: Macroprolactin is a signifi cant cause of misdiagnosis, unnecessary investigation, and inappropriate treatment and hence it is useful to screen all patients with high PRL levels with PEG precipitation and to apply GFC to samples with recoveries <50%.