A case of aspartate aminotransferase macroenzyme

Ann Clin Biochem 2008;45:320-322
doi:10.1258/acb.2007.007063
© 2008 Association for Clinical Biochemistry

 

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Case Reports


J Cabrera-Abreu1,
R Jain2,
P Robinson1,
S Edees2 and
T Staughton1


1 Department of Clinical Biochemistry;
2 Department of Paediatrics, Royal Berkshire Hospital, Craven Road, Reading RG1 5AN, UK


Corresponding author: Dr J Cabrera-Abreu. Email: jose.cabrera-abreu{at}royalberkshire.nhs.uk

Aspartate aminotransferase (AST) macroenzyme can result in elevatedAST activity in patients with no disease. This case report describesa six-year-old boy who presented to his family doctor with ahistory of chronic constipation and lower back pain. Routineblood tests showed normal creatine kinase activity (CK), normalalanine aminotransferase activity (ALT) but raised AST. Thepatient was referred to a hospital paediatrician for furtherinvestigation of the abnormal AST and back pain. The raisedAST was confirmed as the only biochemical abnormality. Furtherinvestigation with polyethylene glycol, followed by measurementof AST in the supernatant, showed undetectable enzyme activity.The sample was sent to a specialist laboratory where it wasanalysed by Sephacryl S300 gel filtration. This procedure confirmedthe presence of a high molecular mass form of AST. AST macroenzymeshould be considered as a cause of isolated AST increase, whichmay avoid further costly investigations.


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