Macroprolactinemia as a diagnostic pitfall in hyperprolactinemia: a systematic review and quantitative synthesis
Authors' conclusion
In confirmed macroprolactinemia, total prolactin elevation is typically moderate, and post-PEG monomeric prolactin is usually within or near the normal range. The post-PEG monomeric prolactin value, rather than percent recovery alone, is the most informative parameter for distinguishing isolated macroprolactinemia from coexisting true hyperprolactinemia.
Study context
- Population
- Patients with hyperprolactinemia and confirmed macroprolactinemia (polyethylene glycol (PEG) precipitation, gel filtration chromatography (GFC), or both), 22 countries
- Participants
- 2,853 patients45 studies
- Outcome
- Study-level quantitative prolactin in confirmed macroprolactinemia (33 studies)
Methodological detailsstudy-level descriptive synthesis, prospectively registered in PROSPERO, PRISMA 2020, 21 413 screened patients with hyperprolactinemia
- Study-level descriptive synthesis
- Prospectively registered in PROSPERO
- PRISMA 2020
- 21 413 screened patients with hyperprolactinemia
Pooled result
As reported in the abstract
Median study-level central total PRL (IQR 42.0-80.0; range 28.1-137.6)
61.4 ng/mL
Median study-level post-PEG monomeric PRL (IQR 8.3-13.2; range 4.0-17.0)
11.7 ng/mL
Further pooled results
- Median study-level maximum total PRL (IQR 97.0-425.5; range 81.8-663.0)
- 264.5 ng/mL
- Extreme elevations attributable to coexisting prolactinomas
Original publication
Macroprolactinemia as a diagnostic pitfall in hyperprolactinemia: a systematic review and quantitative synthesis. J Clin Endocrinol Metab. Published 22 June 2026. doi:10.
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