[Association of macroprolactinemia in patients presenting with hyperandrogenic symptoms]

ABSTRACT

Hyperprolactinemia is an exclusion criterion for the diagnosis of polycystic ovarian syndrome [PSOS] in women presenting with a combination of clinical or paraclinical hyperandrogenism, menstrual dysfunction and polycystic ovaries following ultrasonography; however hyperprolactinemia is common in hyperandrogenemic women. Macroprolactinemia may account for a significant number of hyperprolactinemic sera including hyperandrogenemic women and this may lead to unnecessary diagnostic and therapeutic procedures and false exclusion of PCOS. The aim of this study was evaluation of macroprolactinemia in women presenting with hyperandrogenemic symptoms and hyperprolactinemia. In a series of 200 hyperandrogenemic women, aged 14-40 years, presenting to the endocrine clinic of Ghaem Hospital between 2004-2006, serum prolactin was measured. If there was significant hyperprolactinemia [>35micro g/L], they were investigated for the presence of macroprolactinemia using the polyethylene glycol precipitation test. Thirty-eight [19%] patients had raised serum prolactin, of whom in 9, the rise was significant. Macroprolactinemia was detected in 5, and they were diagnosed with PCOS. In the remaining 4 patients, there was true hyperprolactinemia It is necessary to rule out macroprolactinemia in women presenting with hyperandrogenemic symptoms and hyperprolactinemia to prevent false exclusion of PCOS, expensive and unnecessary diagnostic procedures and inappropriate use of dopaminergic agonists