A Case of Macroenzyme Aspartate Aminotransferase Mimicking Hepatic Injury

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dc.contributor.authorSchimming, Sarahen
dc.contributor.authorBansal, Jashen
dc.contributor.authorSahebjam, Farhaden
dc.date.accessioned2022-07-06T12:28:01Zen
dc.date.available2022-07-06T12:28:01Zen
dc.date.issued2021-08-19en
dc.date.updated2022-07-05T23:18:31Zen
dc.description.abstractMacroenzymes are high molecular weight complexes that are formed by the binding of normal serum enzymes with circulating immunoglobulins - primarily IgG, IgA, and IgM. These high molecular weight complexes are difficult to clear through the kidneys, therefore they remain persistently elevated in the serum leading to inaccurate diagnoses and unnecessary workup. The prevalence of macroenzymes is relatively rare in the general population; however, it is an important phenomenon to be aware of when working up isolated elevations in serum enzymes. A quick and efficient test for the detection of macroenzymes is the polyethylene glycol precipitation test. Here, we present a case of macro-aspartate aminotransferase masquerading as an underlying hepatobiliary disease ultimately leading to an extensive evaluation before arriving at the correct diagnosis. This case highlights the importance of an accurate and efficient diagnosis of macroenzymes in the serum in order to prevent unnecessary healthcare utilization and also to decrease the psychological burden on the patient.en
dc.description.versionPublished versionen
dc.format.mimetypeapplication/pdfen
dc.identifier.doihttps://doi.org/10.7759/cureus.17311en
dc.identifier.eissn2168-8184en
dc.identifier.issn2168-8184en
dc.identifier.issue8en
dc.identifier.otherPMC8451511en
dc.identifier.pmid34567865en
dc.identifier.urihttp://hdl.handle.net/10919/111132en
dc.identifier.volume13en
dc.language.isoenen
dc.publisherCureusen
dc.relation.urihttps://www.ncbi.nlm.nih.gov/pubmed/34567865en
dc.rightsCreative Commons Attribution 4.0 Internationalen
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/en
dc.subjectast (aspartate aminotransferase)en
dc.subjectimmunoglobulinen
dc.subjectmacroenzymeen
dc.subjectpolyethylene glycolen
dc.subjecttransaminaseen
dc.titleA Case of Macroenzyme Aspartate Aminotransferase Mimicking Hepatic Injuryen
dc.title.serialCureusen
dc.typeArticle - Refereeden
dc.type.dcmitypeTexten
dc.type.otherCase Reportsen
dc.type.othercase-reporten
dcterms.dateAccepted2021-08-19en
pubs.organisational-group/Virginia Techen
pubs.organisational-group/Virginia Tech/VT Carilion School of Medicineen
pubs.organisational-group/Virginia Tech/VT Carilion School of Medicine/Internal Medicineen
pubs.organisational-group/Virginia Tech/VT Carilion School of Medicine/Internal Medicine/General IMen

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