Makroamilazemija kao razlog hiperamilazemije u klinički nejasnim stanjima - prikaz slučaja

Abstract

Macroamylasemia is a rare condition characterized by elevated serum amylase levels due to the existence of macromolecules - complex amylase that cannot be secreted normally by the kidneys due to their size. It is a benign condition that is usually free of marked clinical symptoms and signs. The prevalence of macroamylasemia in the population is between 1 and 2%. The main clinical significance of macromylasemia is that it is often a diagnostic problem because it requires differentiation of this condition from other causes of hyperamylasemia. Therefore, it is rational to avoid unnecessary diagnostics and treatment, which burden both the patient and the health system. Macromalasemia as a diagnosis should be considered in any patient with elevated serum amylase activity in whom serum lipase and urine amylase levels are normal. Laboratory confirmation of the diagnosis of amylasemia rests on tests: electrophoresis or polyethylene glycol precipitation test. This paper presents a patient who has been routinely treated clinically due to non-specific gastrointestinal problems. During laboratory treatment, the patient's serum was found to have elevated amylase values. Additional diagnostics did not identify organic pancreatic diseases or other diseases that may be related to hyperamylasemia, and by calculating the ratio of renal amylase clearance to creatinine clearance of less than 1%, we conclude that it is most likely a macroamylasemia. Specific treatment was not required. The patient comes for a check-up once every 6 months.