Macroamylasemia

Macroamylasemia is the presence of macroamylase in the blood. Macroamylase is a complex of the enzyme amylase bound to other proteins forming a larger molecule.[1] Macroamylase is typically composed of immunoglobulin A (IgA, 70%) and less often of immunoglobulin G (IgG, 30%). The association of amylase with some drugs has also been reported. [2]

The macroamylase molecules are unable to pass through the kidneys and are therefore retained in the blood, leading to elevated levels of amylase in the bloodstream. In contrast, amylase urine levels are normal.[3]

Macroamylasemia is usually a benign condition, and people usually do not experience any symptoms or health problems. In fact, it is often discovered incidentally during a routine blood test. However, in some rare cases, macroamylasemia can cause recurrent abdominal pain or other gastrointestinal symptoms.

Causes

Macroamylasemia is a relatively rare condition, and in most cases, the exact cause is unknown. It can occur in completely healthy individuals without symptoms, in association with autoimmune diseases (such as systemic lupus erythematosus) and other diseases (cancer or inflammatory diseases).[2]

However, there are some risk factors that can increase the likelihood of developing the condition:[4]

Diagnosis and Treatment

Diagnosis of macroamylasemia is typically made by measuring the amylase levels in the blood and urine and performing additional tests to confirm the presence of macroamylase.[5]

Treatment is usually not necessary unless the patient is experiencing symptoms or complications related to the condition.

References
  1. Warshaw, Andrew L; Lee, Kang-Hyun (1978). "Macroamylasemia and other chronic nonspecific hyperamylasemias: Chemical oddities or clinical entities?". The American Journal of Surgery. 135 (4): 488–493. doi:10.1016/0002-9610(78)90025-9. PMID 637193.
  2. Čásenská, Jitka; Franeková, Janka; Mačinga, Peter; Jabor, Antonín (2023). "Significant elevations of serum amylase caused by macroamylase: Case reports and detection possibilities". JCLA Journal of Clinical Laboratory Analysis. 37 (5): e24859. doi:10.1002/jcla.24859. PMC 10098064. PMID 36916750.
  3. Šimac, Daniel Victor; Špelic, Maja; Devcic, Bosiljka; Racki, Sanjin (2017). "Diagnosing macroamylaemia in unexplained hyperamylasemia". Acta Med Croatica. 71: 63–67.
  4. Kleinman, David S.; O'Brien, John F. (1986). "Macroamylasemia". Mayo Foundation for Medical Education and Research. 61 (8): 669–670. doi:10.1016/S0025-6196(12)62033-3. PMID 2425197.
  5. "Macroamylasemia". www.mrlabtest.com. February 2023. Retrieved 20 March 2023.
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