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Manual de Exames


Letra M


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MACROPROLACTINA

Material:

Soro

Instruções de coleta:

Jejum não necessário. Colher de preferência com paciente em repouso.

Informações:

A pesquisa de macroprolactina é importante em todos os casos em que níveis elevados de prolactina forem encontrados, especialmente nos pacientes oligo ou assintomáticos. Assim, procedimentos propedêuticos de alto custo e risco para o paciente podem ser evitados. A prolactina é um hormônio bastante heterogêneo e, do ponto de vista de peso molecular, existem três formas principais em circulação: monômero de 23kDa, dímero (big prolactin) de 45kDa e macroprolactina (big-big prolactin) de peso molecular acima de 150kDa. Em condições normais ou em pacientes com hiperprolactinemia sintomática, predomina em circulação a forma monomérica. A macroprolactina é constituída, na maioria dos casos, por uma associação entre uma molécula de prolactina e uma de IgG, o que leva a uma meia-vida mais longa e atividade biológica menor. A pesquisa da macroprolactina é feita por método de precipitação com polietilenoglicol (PEG) e estudo da recuperação após a precipitação. Se a recuperação pós precipitação é inferior a 30%, considera-se que há predominância de formas de alto PM (macroprolactina). Se a recuperação é superior a 65%, predominam as formas monoméricas. Nos casos de recuperação intermediária, é necessário utilizar a cromatografia do soro em coluna de filtração para caracterização mais apurada. Interferentes: bloqueadores do receptor de dopamina, antidepressivos, drogas para tratamento de hiperprolactinemia e neurolépticos. Bibliografia: GLEZER, Andrea, D'ALVA, Catarina Brasil, BRONSTEIN, Marcello Delano et al. Macroprolactina e incidentaloma hipofisário. Arq Bras Endocrinol Metab, Mar./Apr. 2001, vol.45, no.2, p.190-198. VIEIRA, José Gilberto H. Macroprolactinemia. Arq Bras Endocrinol Metab, Feb. 2002, vol.46, no.1, p.45-50.

Referência:

  • Maior que 60% :Ausência de macroprolactina
  • Entre 30% e 60%:Intermediária
  • Menor que 30% :Presença de macroprolactina (big)
 

Laboratório Bioclinico

Exames de Rotina