Macroenzyme as a Cause of Unexplained Elevation of Aspartate Aminotransferase

SCOTT C. LITIN, JOHN F. O'BRIEN, SARALYN PRUETT, RODNEY W. FORSMAN, MARY F. BURRITT, LLOYD G. BARTHOLOMEW, WILLIAM P. BALDUS

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Abstract

Aspartate aminotransferase (AST) can exist as a macroenzyme by forming a complex with an immunoglobulin. This immunoglobulin-complexed macromolecule can cause an elevation in serum AST activity, which may be detected on routine blood chemistry analysis and erroneously considered to indicate the presence of liver disease. Clinicians should be aware of this phenomenon so patients are not subject to unnecessary procedures. In patients with unexplained AST elevation, liver and muscle disease can be biochemically excluded by the finding of normal serum levels of alanine aminotransferase and creatine kinase. The presence of macro-AST can be determined by exclusion chromatography, electrophoresis, and activation assays with pyridoxal 5-phosphate. The elevated AST values can persist for many years.

Original languageEnglish (US)
Pages (from-to)681-687
Number of pages7
JournalMayo Clinic proceedings
Volume62
Issue number8
DOIs
StatePublished - Jan 1 1987

ASJC Scopus subject areas

  • Medicine(all)

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    LITIN, SCOTT. C., O'BRIEN, JOHN. F., PRUETT, SARALYN., FORSMAN, RODNEY. W., BURRITT, MARY. F., BARTHOLOMEW, LLOYD. G., & BALDUS, WILLIAM. P. (1987). Macroenzyme as a Cause of Unexplained Elevation of Aspartate Aminotransferase. Mayo Clinic proceedings, 62(8), 681-687. https://doi.org/10.1016/S0025-6196(12)65219-7