A Case of Macroenzyme Aspartate Aminotransferase Mimicking Hepatic Injury

Schimming, Sarah; Bansal, Jash; Sahebjam, Farhad

doi:10.7759/cureus.17311

Cited by 4 publications

(7 citation statements)

References 9 publications

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“…Macroenzymes may be present in healthy subjects [ 20 ] and their presence was described in patients with chronic hepatitis C, autoimmune diseases including rheumatoid arthritis, lupus erythematosus, ulcerative colitis, coeliac disease and some neoplastic disorders [ [21] , [22] , [23] ].…”

Section: Discussionmentioning

confidence: 99%

Macroenzymes as a reason for aminotransferases flare in cystic fibrosis patients on CFTR modulators therapy – Report of three cases

Woynarowski,

Sapiejka,

Jóźwiak

et al. 2024

Heliyon

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Section: Discussionmentioning

confidence: 99%

Macroenzymes as a reason for aminotransferases flare in cystic fibrosis patients on CFTR modulators therapy – Report of three cases

Woynarowski,

Sapiejka,

Jóźwiak

et al. 2024

Heliyon

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“…Almost all of the cases were diagnosed by PEG precipitation (Table 3). 2,3,[13][14][15][16][17][18][19] There are many different methods for detecting macro-AST, including GFC, UF, PEG precipitation test, and stored refrigeration at 4°C. 3,6 The final diagnosis of macro-AST was confirmed by the PEG precipitation test.…”

Section: Discussionmentioning

confidence: 99%

“…Almost all of the cases were diagnosed by PEG precipitation (Table 3 ). 2 , 3 , 13 , 14 , 15 , 16 , 17 , 18 , 19 …”

Section: Discussionmentioning

confidence: 99%

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Persistently high serum aspartate aminotransferase level in an asymptomatic young patient

Pei,

Zhao,

Jiang

et al. 2023

Clinical Case Reports

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Key Clinical MessageWe report a young man with isolated elevated AST. He had no other evidence of liver or other related diseases. All the tests and examination reports were negative. The final diagnosis of macro‐AST was confirmed by PEG precipitation tests.AbstractElevated liver enzymes, such as alanine aminotransferase (ALT) and aspartate aminotransferase (AST), may commonly indicate liver injury. However, macro‐AST is generally a benign condition that may be considered as pathologic by clinicians. A young man with isolated elevated AST for more than 10 years who have taken extensive tests and examinations was diagnosed with macro‐AST in our article. Thus, in patients with isolated AST‐elevation, polyethylene glycol (PEG) precipitation test was recommended to test whether macro‐AST could be diagnosed.

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“…There are numerous methods for macro-AST identification in human blood serum samples such as ultracentrifugation, gel filtration chromatography (GFC), immunofixation electrophoresis (IE) or polyethylene glycol (PEG) precipitation assays ( Table 1 ) [ 14 – 17 ].…”

Section: Laboratory Diagnostic Methods Of Macro-astmentioning

confidence: 99%

Macro-Aspartate Aminotransferase and Its Laboratory Detection: A Case Report

Aleknavičiūtė-Valienė,

Černiauskas,

Riauka

et al. 2023

AML

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Background. Increased enzyme activity in human blood serum is usually associated with the existence of disease. On the other hand, enzyme activity can also be elevated in the presence of benign conditions, such as macro-enzymes. Macro-enzymes could lead to highly unnecessary and invasive procedures which may cause complications to the patient and an extra cost for the hospital. Therefore, it is important to diagnose this condition in order to avoid unnecessary clinical tests.Case Presentation. We present a case of a 71-year-old asymptomatic female with persistent elevation of AST who was referred to our hospital for additional testing for underlying liver disease. By using polyethylene glycol (PEG) precipitation assay, we were able to identify macro-AST. This helped to avoid the high-risk liver biopsy procedure.Conclusion. In the case of an isolated elevation of AST activity with no clinical indications of liver disease, diagnostic work-up for macro-AST should always be considered by physicians.

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A Case of Macroenzyme Aspartate Aminotransferase Mimicking Hepatic Injury

Cited by 4 publications

References 9 publications

Macroenzymes as a reason for aminotransferases flare in cystic fibrosis patients on CFTR modulators therapy – Report of three cases

Macroenzymes as a reason for aminotransferases flare in cystic fibrosis patients on CFTR modulators therapy – Report of three cases

Persistently high serum aspartate aminotransferase level in an asymptomatic young patient

Macro-Aspartate Aminotransferase and Its Laboratory Detection: A Case Report

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