2019
DOI: 10.7759/cureus.5042
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Macro-aspartate Aminotransferase: Misleading Finding in a Patient with Non-alcoholic Fatty Liver Disease

Abstract: Persistent elevation of aspartate aminotransferase (AST) activity in serum due to the presence of a macro-enzyme form of AST (macro-AST) may lead to diagnostic confusion in many clinical conditions, particularly in those associated with chronic liver disease. We present a case of macro-AST in a patient with non-alcoholic fatty liver disease in which polyethylene glycol precipitation confirmed the cause of disproportionately elevated AST as macro-AST.

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Cited by 8 publications
(11 citation statements)
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“…The most important part of determination of macroamylase is to prevent unnecessary invasive examinations. As described above (Cases 1–5) and also in another described case reports in the literature, for example Sharma et al, 32 who described case report of patient with macro‐AST who underwent unnecessary examination, liver biopsy included.…”
Section: Discussionmentioning
confidence: 81%
“…The most important part of determination of macroamylase is to prevent unnecessary invasive examinations. As described above (Cases 1–5) and also in another described case reports in the literature, for example Sharma et al, 32 who described case report of patient with macro‐AST who underwent unnecessary examination, liver biopsy included.…”
Section: Discussionmentioning
confidence: 81%
“…Macro-AST has been described in a few case reports and is an uncommon, benign etiology of isolated elevation in AST levels. Prevalence appears to be lower than other macro-enzyme forms with macro-amylasemia being the most common [3]. Macro-AST can be associated with immune-related and neoplastic disorders but is most often benign [4].…”
Section: Discussionmentioning
confidence: 97%
“…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%
“…Macroenzymes, high molecular mass complexes of plasma enzymes with immunoglobulins (IgG, IgA, or IgM), are rarely detected in the general healthy population 1 . Elevated enzyme activities in plasma may sometimes attribute to the presence of macroenzymes, which reduce plasma clearance and prolonged half‐life 2 …”
Section: Introductionmentioning
confidence: 99%
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