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Here are the anonymised responses so far. They are in order of receipt. Many thanks and sorry if I missed including any who replied. They show a uniformity of view that checking for macroprolactin still is worthwhile. ---------------------------------------------------------------------------- ---------------------------------------------------------------------------- --------------------- I think the incidence is lower but we are still seeing these. Patients previously shown to be macro positive on the Centaur that have been repeated on the Roche have in the few cases done so far have all been positive. We currently have no intention of stopping screening. ---------------------------------------------------------------------------- ---------------------------------------------------------------------------- ------------------ We do still see raised prolactins due to macroprolactin. Although it is a lot less sensitive to macroprolactins than the old method, it is still affected. ---------------------------------------------------------------------------- ---------------------------------------------------------------------------- -------------------- Like you, we are still checking! Interestingly I reported one today on a female patient on whom we previously sent blood to Southend for Gel filtration. In 2002 she had an estimated monomeric level of 1350 plus recovery after PEG of 55% so that our result was 2746. Now her prolactin on the Roche E170 is 1255 with a recovery of 61% - suggesting that this is mostly monomeric I guess. ญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญ--------------------------------------- ---------------------------------------------------------------------------- ---------------------------------------------------------- 4% of hyperprolactinemic samples (> 20ตg/L for men or > 25ตg/L for women) have a strictly normal monomeric prolactin result (< 11.3 ตg/L for men or <16.5 ตg/L for women). 20ตg/L and 25ตg/L are the thresholds frequently used by our clinicians. We only consider prolactin and monomeric prolactin results, not the macroprolactin percentage. ---------------------------------------------------------------------------- ---------------------------------------------------------------------------- ---------------------- We have changed the cut-off at which we screen for macroprolactin (we now screen only when prolactin >700) but have not done away with checking altogether. Like you, we still see the occasional positive for macroprolactin on the new Roche method, but it is a rare event rather than a common occurrence. We haven't been brave enough to stop screening altogether - it's relatively simple to do and saves a lot of bother for the patient if that is the cause of their high prolactin. In our experience, the new method is certainly not completely immune to interference from macroprolactin. ---------------------------------------------------------------------------- ------------------------------------ There is a timely article in this month's (May) issue of Clin Lab Science on Prolactin that addresses this very issue. The article was written by Michael Fahie-Wilson and is available through the AACC website. http://www.aacc.org/AACC/ <http://www.aacc.org/AACC/> My recommendation is to continue to perform PEG on all patient samples with an elevated prolactin. ---------------------------------------------------------------------------- ------------------------------------- Question: The current Roche Modular prolactin kit is more specific for monomeric prolactin and consequently now only has occasional significant interference by macroprolactin, compared to the previous formulation in which it was quite common. We are still checking high samples by the PEG precipitation technique. I wondered if any Modular users are still seeing a significant number of macroprolactinaemia samples with the current kit. If not have any of you been brave enough to stop checking high prolactin samples for macroprolactin? Regards Steve This electronic message contains information from Brighton and Sussex University Hospitals NHS Trust, which may be privileged or confidential. The information is intended to be for the use of the individual(s) or entity named above. If you are not the intended recipient be aware that any disclosure, copying, distribution or use of the contents of this information is prohibited. If you have received this electronic message in error, please notify us immediately at [log in to unmask] This Trust is committed to openness and transparency, and this commitment is supported by the Freedom of Information Act 2000. 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