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Prevalence of Macroprolactin in Hyperprolactinemic patients receiving Anti-psychotics

Background: Prolactin (PRL) hormone circulates in the blood in three forms, mono-prolactin which constitutes 85 % of prolactin in healthy and hyperprolactinemia conditions, a dimeric prolactin (big PRL) and polymeric PRL (big-big prolactin or Macroprolactin). Macroprolactin in normal conditions is not exceeding 2% of the total serum prolactin and had no biological activity. In some cases, of hyperprolactinemia the dominant form becomes MaPRL and exceeding the 2% percentage of total leading to misdiagnosis of hyperprolactinemia and un-necessary radiological investigations. The aim of this study is to detect the prevalence of MaPRL in Psychiatric patients with hyperprolactinemia due to anti-psychotic medications at Al Masarra hospital. Material and methods: The study was conducted on 190 samples from patients with high prolactin in Al Masarra Hospital either inpatients or out-patient clinics either male or non-lactating not pregnant female. The measurement of Prolactin level was measured by the automated analyser COBAS e411, Roche Diagnostic. Macroprolactin was precipitated by using Polyethylene glycol (PEG). Results: Prevalence of Macroprolactin was 10.5 % of hyperprolactinemic patients receiving antipsychotics. There was a statistically significant difference in gender between the symptomatic and asymptomatic group. There was no significant difference in medications used between the symptomatic and asymptomatic group and there was a statistically significant difference in total Prolactin & Macroprolactin between males and females. Conclusions: Investigation for Macroprolactin should be done in every hyperprolactinemia patient who is receiving antipsychotics more especially the asymptomatic cases to avoid unnecessary radiological imaging and treatment.