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Hiperamilazeminin Nadir Bir Nedeni: Makroamilazemi

Year 2017, Volume: 18 Issue: 1, 58 - 60, 01.04.2017

Abstract

Artmış serum amilaz aktivitesi akut pankreatit ve tükrük bezi enflamasyonunda sıklıkla görülmekle birlikte nadir olarak, tedavi gerektirmeyen benign bir fenomen olan makroamilazemide de görülmektedir. Hiperamilazemi karın ağrısı ile başvuran hastalarda zaman zaman tanısal karışıklığa yol açabilen bir laboratuvar bulgusudur. Serum amilaz düzeyi yüksekliği ve karın ağrısı, makroamilazemik hastaların yanlış akut pankreatit tanısı almalarına yol açabilir. Karın ağrısı ve hiperamilazemisi olan ancak pankreatiti destekleyen görüntüleme bulgusu olmayan hastalarda makroamilazemi de akılda bulundurulmalıdır. Burada karın ağrısı ve kalıcı amilaz yüksekliği ile başvuran makroamilazemili bir olguyu sunmaktayız. Hastanın şikayeti olmadan, üç ay sonra poliklinik takibinde lipaz değeri normal iken amilaz yüksekliği (450 U/L) devam etmekteydi

References

  • 1. Gallucci F, Buono R, Ferrara L, Madrid E, Miraglia S, Uomo G. Chronic asymptomatic hyperamylasemia unrelated to pancreatic diseases. Adv Med Sci 2010; 55: 143-5.
  • 2. Turkçapar N, Özden A. Makroenzimler. Güncel Gastroenteroloji 2005; 9: 161-6.
  • 3. Sturk A, Sanders GT. Macro enzymes: prevalence, composition, detection and clinical relevance. J Clin Chem Clin Biochem 1990; 28: 65-81.
  • 4. Turecky L. Macroenzymes and their clinical significance. Bratisl Lek Listy 2004; 105: 260-3.
  • 5. Galasso PJ, Litin SC, O’Brien JF. The macroenzymes: a clinical review. Mayo Clin Proc 1993; 68: 349-54.
  • 6. Wilding P, Cooke WT, Nicholson GI. Globulin-bound amylase: A cause of persistently elevated levels in serum. Ann Intern Med 1964; 60: 1053-59.
  • 7. Rabsztyn A, Green PH, Berti I, Fasano A, Perman JA, Horvath K. Macroamylasemia in patients with celiac disease. Am J Gastroenterol 2001; 96: 1096-100.
  • 8. Fujimura Y, Nishishita C, Uchida J, Iida M. Macroamylasemia associated with ulcerative colitis. J Mol Med (Berl) 1995; 73: 95-7.
  • 9. Venkataraman D, Howarth L, Beattie RM, Afzal NA. A very high amylase can be benign in paediatric Crohn’s disease. BMJ Case Rep 2012; 2012.
  • 10. Sagristani M, Guariglia R, Pocali B, De Rienzo M, Guastafierro S, Romano G, et al. Macroamylasemia in a patient with multiple myeloma. Leuk Lymphoma 2002; 43: 1705-7.
  • 11. Nakayama S, Yokote T, Kobayashi K, Hirata Y, Akioka T, Miyoshi T, et al. Macroamylasemia in a patient with acute myeloid leukemia. Leuk Res 2009; 33: e121-3.
  • 12. Goto H, Wakui H, Komatsuda A, Imai H, Miura AB, Fujita K. Simultaneous macroamylasemia and macrolipasemia in a patient with systemic lupus erythematosus in remission. Intern Med 2000; 39: 1115-8.
  • 13. Cutolo M, Sulli A, Barone A, Picciotto A, Mangraviti S, Seriolo B, et al. Macroamylasemia: a possible cause of unexplained hyperamylasemia in rheumatoid arthritis. Br J Rheumatol 1995; 34: 290-2.
  • 14. Cho SY, Lee A, Lee HJ, Suh JT. Overlapping presence of macroamylasemia and hyperamylasemia in acute pancreatitis. Korean J Lab Med 2011; 31: 98-100.

A Rare Cause of Hyperamylasemia: Macroamylasemia

Year 2017, Volume: 18 Issue: 1, 58 - 60, 01.04.2017

Abstract

Elevated serum amylase activity is commonly seen in acute pancreatitis and salivary gland inflammation, but also rarely seen in a benign phenomenon, macroamylasemia, that does not require treatment. Hyperamylasemia is a laboratory finding that may cause diagnostic failure occasionally in patients presenting with abdominal pain. Elevated serum amylase levels and abdominal pain may lead to misdiagnosis as acute pancreatitis in macroamylasemic patients. Macroamylasemia should be considered in patients with abdominal pain and hyperamylasemia but without imaging findings of pancreatitis. Here, we present a patient with macroamylasemia who had abdominal pain and persistent hyperamylasemia. The patient had no complaints but persisting hyperamylasemia (450 U/L) and normal lipase activity at the follow-up outpatient visit three months later.

References

  • 1. Gallucci F, Buono R, Ferrara L, Madrid E, Miraglia S, Uomo G. Chronic asymptomatic hyperamylasemia unrelated to pancreatic diseases. Adv Med Sci 2010; 55: 143-5.
  • 2. Turkçapar N, Özden A. Makroenzimler. Güncel Gastroenteroloji 2005; 9: 161-6.
  • 3. Sturk A, Sanders GT. Macro enzymes: prevalence, composition, detection and clinical relevance. J Clin Chem Clin Biochem 1990; 28: 65-81.
  • 4. Turecky L. Macroenzymes and their clinical significance. Bratisl Lek Listy 2004; 105: 260-3.
  • 5. Galasso PJ, Litin SC, O’Brien JF. The macroenzymes: a clinical review. Mayo Clin Proc 1993; 68: 349-54.
  • 6. Wilding P, Cooke WT, Nicholson GI. Globulin-bound amylase: A cause of persistently elevated levels in serum. Ann Intern Med 1964; 60: 1053-59.
  • 7. Rabsztyn A, Green PH, Berti I, Fasano A, Perman JA, Horvath K. Macroamylasemia in patients with celiac disease. Am J Gastroenterol 2001; 96: 1096-100.
  • 8. Fujimura Y, Nishishita C, Uchida J, Iida M. Macroamylasemia associated with ulcerative colitis. J Mol Med (Berl) 1995; 73: 95-7.
  • 9. Venkataraman D, Howarth L, Beattie RM, Afzal NA. A very high amylase can be benign in paediatric Crohn’s disease. BMJ Case Rep 2012; 2012.
  • 10. Sagristani M, Guariglia R, Pocali B, De Rienzo M, Guastafierro S, Romano G, et al. Macroamylasemia in a patient with multiple myeloma. Leuk Lymphoma 2002; 43: 1705-7.
  • 11. Nakayama S, Yokote T, Kobayashi K, Hirata Y, Akioka T, Miyoshi T, et al. Macroamylasemia in a patient with acute myeloid leukemia. Leuk Res 2009; 33: e121-3.
  • 12. Goto H, Wakui H, Komatsuda A, Imai H, Miura AB, Fujita K. Simultaneous macroamylasemia and macrolipasemia in a patient with systemic lupus erythematosus in remission. Intern Med 2000; 39: 1115-8.
  • 13. Cutolo M, Sulli A, Barone A, Picciotto A, Mangraviti S, Seriolo B, et al. Macroamylasemia: a possible cause of unexplained hyperamylasemia in rheumatoid arthritis. Br J Rheumatol 1995; 34: 290-2.
  • 14. Cho SY, Lee A, Lee HJ, Suh JT. Overlapping presence of macroamylasemia and hyperamylasemia in acute pancreatitis. Korean J Lab Med 2011; 31: 98-100.
There are 14 citations in total.

Details

Other ID JA66YS35KA
Journal Section Case Report
Authors

Adil Coşkun This is me

Deniz Çetin This is me

M. Hadi Yaşa This is me

A. Önder Karaoğlu This is me

Publication Date April 1, 2017
Published in Issue Year 2017 Volume: 18 Issue: 1

Cite

EndNote Coşkun A, Çetin D, Yaşa MH, Karaoğlu AÖ (April 1, 2017) A Rare Cause of Hyperamylasemia: Macroamylasemia. Meandros Medical And Dental Journal 18 1 58–60.