Isolated elevation of aspartate aminotransferase (AST) in an asymptomatic patient due to macro-AST
| Autor: | Eva Martín Salido, Arturo González Raya, Ramón Coca Zúñiga |
|---|---|
| Rok vydání: | 2018 |
| Předmět: |
0301 basic medicine
Microbiology (medical) medicine.medical_specialty Clinical Biochemistry Early detection Asymptomatic Gastroenterology digestive system Polyethylene Glycols Diagnosis Differential 03 medical and health sciences 0302 clinical medicine aspartate aminotransferase macro-AST macro-enzyme Liver enzyme Internal medicine Enzyme Stability medicine Immunology and Allergy Humans Peg precipitation Aspartate Aminotransferases health care economics and organizations Alternative methods Laboratory methods medicine.diagnostic_test business.industry Biochemistry (medical) Public Health Environmental and Occupational Health Temperature nutritional and metabolic diseases Hematology Middle Aged digestive system diseases liver enzymes Medical Laboratory Technology stomatognathic diseases 030104 developmental biology Potential harm 030220 oncology & carcinogenesis Liver biopsy polyethylene glycol Asymptomatic Diseases Female Brief Reports medicine.symptom business Blood Chemical Analysis |
| Zdroj: | Journal of clinical laboratory analysis. 33(2) |
| ISSN: | 1098-2825 |
| Popis: | Background A rare and benign cause of isolated aspartate aminotransferase (AST) increase is due to the presence of macro aspartate aminotransferase (macro-AST). Macro-AST is not usually considered by clinicians, leading to a large number of unnecessary and even invasive tests before diagnosed. Most commonly used laboratory methods for detection of macro-enzymes are precipitation with polyethylene glycol (PEG), ultracentrifugation and gel filtration chromatography (GFC). Methods We report a case of an asymptomatic patient with persistent isolated AST elevation. PEG precipitation and an alternative method based on the low stability of this macro-enzyme were performed on the patient serum. Results Macro-AST was early detected by the laboratory observing a significant decrease in AST concentrations when the serum is stored at 4oC. Conclusions Macro-AST detection based in this method can be very useful as screening, especially in those laboratories where other technologies are not available. Macro-AST must be considered as cause of unexplained isolated AST elevations before prior investigations to avoid the consequent cost and potential harm to the patient. In our case, early detection of macro-AST with this method avoided unnecessary treatment and invasive test such as liver biopsy. |
| Databáze: | OpenAIRE |
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