Persistently raised aspartate aminotransferase (AST) due to macro-AST in a rheumatology clinic

Macrocomplexes between immunoglobins and aspartate aminotransferase (macro-AST) may result in persistently increased AST concentration. The presence of macro-AST in patients has been implicated in unnecessary investigations of abnormal liver function tests. We report the case of a 44-year-old female...

Full description

Saved in:
Bibliographic Details
Published inDiagnosis (Berlin, Germany) Vol. 2; no. 2; pp. 137 - 140
Main Authors Mbagaya, Wycliffe, Foo, Joanne, Luvai, Ahai, King, Claire, Mapplebeck, Sarah, Gough, Andrew, Jassam, Nuthar
Format Journal Article
LanguageEnglish
Published Germany De Gruyter 01.06.2015
Subjects
AST
liver enzymes
macro-AST
macroenzyme
liver enzymes
macro-AST
macroenzyme
AST
Online AccessGet full text

Cover

More Information
Summary:Macrocomplexes between immunoglobins and aspartate aminotransferase (macro-AST) may result in persistently increased AST concentration. The presence of macro-AST in patients has been implicated in unnecessary investigations of abnormal liver function tests. We report the case of a 44-year-old female who presented to the rheumatology clinic with a 12-months’ history of constant widespread pain affecting her limbs and was found to have an elevated AST concentration. Further information from her GP revealed a 14-years’ history of elevated AST with otherwise normal liver function. Previous abdominal ultrasound and two liver biopsies carried out 2 years apart were normal. This prompted further analytical investigation by the biochemistry department which identified macro-AST as the cause. This case illustrates that persistently raised isolated AST concentration with no other abnormal indices may warrant macroenzyme analysis potentially avoiding unnecessary invasive investigations.
ISSN:2194-8011
2194-802X
DOI:10.1515/dx-2014-0065