Journal of Human Reproductive Science
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CASE REPORT Table of Contents   
Year : 2021  |  Volume : 14  |  Issue : 2  |  Page : 206-210
Persistent idiopathic prolactin elevation merits macroprolactin estimation: A case report and review of literature

1 Department of Endocrinology, Christian Medical College and Hospital, Vellore, Tamil Nadu, India
2 Department of Clinical Biochemistry, Christian Medical College and Hospital, Vellore, Tamil Nadu, India
3 Department of Reproductive Medicine Unit, Christian Medical College and Hospital, Vellore, Tamil Nadu, India

Correspondence Address:
Dr. Kripa Elizabeth Cherian
Department of Endocrinology, Diabetes and Metabolism, Christian Medical College and Hospital, Vellore - 632 004, Tamil Nadu
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/jhrs.jhrs_168_20

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The prevalence of hyperprolactinemia ranges from about 0.4% in an unselected adult population to as high as 9%–17% in women with reproductive disorders. It may cause infertility in about 11% of the oligospermic males. Rarely, the cause of persistently elevated prolactin remains obscure even after thorough work up. Macroprolactinemia is biologically inactive, high-molecular-weight form of prolactin resulting from its binding to immunoglobulin G, causing a decrease in its clearance. We report the case of a 35-year-old female, detected to have hyperprolactinemia on multiple tests, during routine work up for primary infertility. Secondary causes for the same were ruled out. A magnetic resonance imaging (MRI) of the brain excluded a prolactinoma. This prompted an estimation of prolactin levels after polyethylene glycol precipitation which showed a decrease to 5.58 ng/mL, with <40% recovery, confirming the presence of macroprolactin. Thus, persistently elevated prolactin levels in the background of negative neurological imaging necessitate the estimation of macroprolactin.

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