Test Catalog

Test Id : MCRPL

Macroprolactin, Serum

Useful For
Suggests clinical disorders or settings where the test may be helpful

Determining biologically active levels of prolactin, in asymptomatic patients with elevated prolactin levels

 

Ruling out the presence of macroprolactin

Profile Information
A profile is a group of laboratory tests that are ordered and performed together under a single Mayo Test ID. Profile information lists the test performed, inclusive of the test fee, when a profile is ordered and includes reporting names and individual availability.

Test Id Reporting Name Available Separately Always Performed
TOPRL Prolactin,Total,S Yes, (order PRL) Yes
PEGPR Prolactin,Unprecipitated,S No Yes

Method Name
A short description of the method used to perform the test

TOPRL: Electrochemiluminescent Immunoassay

PEGPR: Polyethylene Glycol (PEG) Precipitation Followed by Electrochemiluminescent Immunoassay

NY State Available
Indicates the status of NY State approval and if the test is orderable for NY State clients.

Yes

Reporting Name
Lists a shorter or abbreviated version of the Published Name for a test

Macroprolactin, S

Aliases
Lists additional common names for a test, as an aid in searching

PRL (Prolactin)

Prolactin (PRL)

Prolactin, Macro

Monomeric

Specimen Type
Describes the specimen type validated for testing

Serum

Specimen Required
Defines the optimal specimen required to perform the test and the preferred volume to complete testing

Patient Preparation: For 12 hours before specimen collection do not take multivitamins or dietary supplements containing biotin (vitamin B7), which is commonly found in hair, skin, and nail supplements and multivitamins.

Container/Tube:

Preferred: Serum gel

Acceptable: Red top

Specimen Volume: 1 mL

Collection Instructions: Spin down and separate serum from clot.

Forms

If not ordering electronically, complete, print, and send an Oncology Test Request (T729) with the specimen.

Specimen Minimum Volume
Defines the amount of sample necessary to provide a clinically relevant result as determined by the Testing Laboratory

0.6 mL

Reject Due To
Identifies specimen types and conditions that may cause the specimen to be rejected

Gross hemolysis Reject
Gross lipemia OK

Specimen Stability Information
Provides a description of the temperatures required to transport a specimen to the performing laboratory, alternate acceptable temperatures are also included

Specimen Type Temperature Time Special Container
Serum Refrigerated (preferred) 7 days
Frozen 90 days
Ambient 24 hours

Useful For
Suggests clinical disorders or settings where the test may be helpful

Determining biologically active levels of prolactin, in asymptomatic patients with elevated prolactin levels

 

Ruling out the presence of macroprolactin

Clinical Information
Discusses physiology, pathophysiology, and general clinical aspects, as they relate to a laboratory test

Prolactin is secreted by the anterior pituitary gland under negative control by dopamine, which is secreted by the hypothalamus. The only physiological function of prolactin is the stimulation of milk production. In normal individuals, the prolactin concentration in blood rises in response to physiologic stimuli such as nipple stimulation, sleep, exercise, sexual intercourse, and hypoglycemia. Certain medications, (eg, phenothiazines, metoclopramide, risperidone, selective serotonin reuptake inhibitors, estrogens, verapamil) may also cause hyperprolactinemia. Pathologic causes of hyperprolactinemia include prolactin-secreting pituitary adenoma (prolactinoma), diseases of the hypothalamus, primary hypothyroidism, section compression of the pituitary stalk, chest wall lesions, renal failure, and ectopic tumors.

 

Hyperprolactinemia may also be caused by the presence of a high-molecular-mass complex of prolactin called macroprolactin (typically due to prolactin bound to immunoglobulin). In this situation, the patient is asymptomatic. Hyperprolactinemia attributable to macroprolactin is a frequent cause of misdiagnosis and mismanagement of patients. Macroprolactin should be considered if, in the presence of elevated prolactin levels, signs and symptoms of hyperprolactinemia are absent, or pituitary imaging studies are not informative.

Reference Values
Describes reference intervals and additional information for interpretation of test results. May include intervals based on age and sex when appropriate. Intervals are Mayo-derived, unless otherwise designated. If an interpretive report is provided, the reference value field will state this.

PROLACTIN, TOTAL

Males

<18 years: not established

> or =18 years: 4.0-15.2 ng/mL

Females

<18 years: not established

> or =18 years: 4.8-23.3 ng/mL

 

PROLACTIN, UNPRECIPITATED

Males

<18 years: not established

> or =18 years: 2.7-13.1 ng/mL

Females

<18 years: not established

> or =18 years: 3.4-18.5 ng/mL

 

When the percent of the precipitated (complexed) prolactin fraction of the total prolactin is 60% or less, the result is considered negative for macroprolactin.

Interpretation
Provides information to assist in interpretation of the test results

When the fraction (percentage) of polyethylene glycol (PEG)-precipitated (complexed) prolactin is 60% or less of total prolactin, the specimen is considered negative for macroprolactin. When total prolactin exceeds the upper reference limit and macroprolactin is negative, other causes for hyperprolactinemia should be explored.

 

When the fraction (percentage) of polyethylene glycol (PEG)-precipitated (complexed) prolactin is above 60%, the specimen is considered positive for the presence of macroprolactin.

 

Following polyethylene glycol (PEG)-precipitation, a patient whose unprecipitated prolactin concentration is greater than the upper limit of the unprecipitated prolactin reference interval may have hyperprolactinemia.

 

See PRL / Prolactin, Serum for interpretation of prolactin levels.

Cautions
Discusses conditions that may cause diagnostic confusion, including improper specimen collection and handling, inappropriate test selection, and interfering substances

Demonstration of the presence of macroprolactin does not exclude the possibility of concomitant presence of pituitary adenoma. Results should be interpreted in conjunction with clinical findings.

Clinical Reference
Recommendations for in-depth reading of a clinical nature

1. Fahie-Wilson M: In Hyperprolactinemia, Testing for Macroprolactin is Essential. Clin Chem 2003;49(9):1434-1436

2. Gibney J, Smith TP, McKenna TJ: Clinical relevance of macro-prolactin. Clin Endocrinol 2005 Jun;62:633-643

Method Description
Describes how the test is performed and provides a method-specific reference

TOPRL:

The Roche cobas e immunoassay Prolactin II method employs 2 monoclonal antibodies specifically directed against prolactin. A biotinylated monoclonal antibody and a second monoclonal antibody labeled with a ruthenium complex react with prolactin in the sample to form a sandwich complex. After the addition of streptavidin-coated microparticles, the complex becomes bound to the solid phase via interaction of biotin and streptavidin. Application of a voltage to the electrode then induces chemiluminescent emission, which is measured.(Package insert: Elecsys Prolactin II, V 8.0, Roche 2017)

 

PEGPR:

Macroprolactin and oligomers can be precipitated by using a 25 % aqueous PEG solution (ratio 1+1). After centrifugation, the supernatant containing monomeric prolactin is used in the Elecsys Prolactin II assay in the same way as a native sample. The dilution effect which occurs during sample pretreatment and the coprecipitation of monomeric prolactin must be taken into consideration. Precipitated prolactin is calculated by subtracting the unprecipitated prolactin value from the total prolactin. The percentage of precipitated prolactin to total prolactin indicates the presence or absence of macroprolactin.(Package insert: Elecsys Prolactin II, V 8.0, Roche 2017)

PDF Report
Indicates whether the report includes an additional document with charts, images or other enriched information

No

Day(s) Performed
Outlines the days the test is performed. This field reflects the day that the sample must be in the testing laboratory to begin the testing process and includes any specimen preparation and processing time before the test is performed. Some tests are listed as continuously performed, which means that assays are performed multiple times during the day.

Monday through Sunday

Report Available
The interval of time (receipt of sample at Mayo Clinic Laboratories to results available) taking into account standard setup days and weekends. The first day is the time that it typically takes for a result to be available. The last day is the time it might take, accounting for any necessary repeated testing.

Same day/1 to 3 days

Specimen Retention Time
Outlines the length of time after testing that a specimen is kept in the laboratory before it is discarded

7 days

Performing Laboratory Location
Indicates the location of the laboratory that performs the test

Rochester

Fees
Several factors determine the fee charged to perform a test. Contact your U.S. or International Regional Manager for information about establishing a fee schedule or to learn more about resources to optimize test selection.

  • Authorized users can sign in to Test Prices for detailed fee information.
  • Clients without access to Test Prices can contact Customer Service 24 hours a day, seven days a week.
  • Prospective clients should contact their Regional Manager. For assistance, contact Customer Service.

Test Classification
Provides information regarding the medical device classification for laboratory test kits and reagents. Tests may be classified as cleared or approved by the US Food and Drug Administration (FDA) and used per manufacturer instructions, or as products that do not undergo full FDA review and approval, and are then labeled as an Analyte Specific Reagent (ASR) product.

This test has been cleared, approved, or is exempt by the US Food and Drug Administration and is used per manufacturer's instructions. Performance characteristics were verified by Mayo Clinic in a manner consistent with CLIA requirements.

CPT Code Information
Provides guidance in determining the appropriate Current Procedural Terminology (CPT) code(s) information for each test or profile. The listed CPT codes reflect Mayo Clinic Laboratories interpretation of CPT coding requirements. It is the responsibility of each laboratory to determine correct CPT codes to use for billing.

CPT codes are provided by the performing laboratory.

84146 x 2

LOINC® Information
Provides guidance in determining the Logical Observation Identifiers Names and Codes (LOINC) values for the order and results codes of this test. LOINC values are provided by the performing laboratory.

Test Id Test Order Name Order LOINC Value
MCRPL Macroprolactin, S 78993-3
Result Id Test Result Name Result LOINC Value
Applies only to results expressed in units of measure originally reported by the performing laboratory. These values do not apply to results that are converted to other units of measure.
PROU Prolactin,Unprecipitated,S 38926-2
RATIO Prolactin, Percent PEG-precipitated 51441-4
CMT42 Interpretive Comment 48767-8
T_PRL Prolactin,Total,S 20568-2

Test Setup Resources

Setup Files
Test setup information contains test file definition details to support order and result interfacing between Mayo Clinic Laboratories and your Laboratory Information System.

Excel | Pdf

Sample Reports
Normal and Abnormal sample reports are provided as references for report appearance.

Normal Reports | Abnormal Reports

SI Sample Reports
International System (SI) of Unit reports are provided for a limited number of tests. These reports are intended for international account use and are only available through MayoLINK accounts that have been defined to receive them.

SI Normal Reports | SI Abnormal Reports