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Michael J Diver, David L Ewins, Richard C Worth, Shirley Bowles, James A Ahlquist, Michael N Fahie-Wilson, An Unusual Form of Big, Big (Macro) Prolactin in a Pregnant Patient, Clinical Chemistry, Volume 47, Issue 2, 1 February 2001, Pages 346–348, https://doi.org/10.1093/clinchem/47.2.346
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It is well recognized that circulating prolactin may exist in several forms, including little (monomeric), big, and big, big (macroprolactin) prolactin with molecular masses of 23, 50, and 150–170 kDa, respectively (1).
We report the case of a 30-year-old woman who initially attended her primary care physician because of the onset of painful irregular periods. Her cycle usually was regular, but she had had an 8-week interval of amenorrhea, followed by a particularly painful bleed for which she sought medical advice. Before this, and subsequently, her menstruation had been completely regular with a 28-day cycle. She had no other problems.
The patient’s initial serum prolactin was recorded as 15 800 mIU/L (∼530 μg/L) in a Bayer Immuno 1TM assay (Bayer Corporation). Other investigations at the time were entirely normal.
When the subject was monitored 2 months later, she was symptomless and menstruating regularly; her serum prolactin, using the same assay as before, was 8440 mIU/L (∼270 μg/L). Pituitary imaging by magnetic resonance was normal. She had, of choice, never been pregnant.
