Macroamylasaemia after treatment with hydroxyethyl starch

Area of Science:

• Biochemistry
• Clinical Chemistry
• Pharmacology

Background:

• Hydroxyethyl starch (HES) is a plasma volume expander.
• Elevated serum amylase can indicate pancreatic disease.
• The relationship between HES infusion and serum amylase is not fully understood.

Purpose of the Study:

• To investigate the effect of HES infusion on serum amylase levels.
• To determine the mechanism behind HES-induced hyperamylasemia.
• To assess the clinical significance of HES-related hyperamylasemia.

Main Methods:

• Infusion of 6% HES into 54 patients.
• Measurement of serum amylase and lipase levels.
• Assessment of renal function (glomerular filtration rate).
• Gel filtration to analyze HES-amylase complex formation.

Main Results:

• Serum amylase increased in 51 of 54 patients after HES infusion.
• Maximum amylase increase was not influenced by renal function.
• Hyperamylasemia persisted for at least 72 hours in patients with renal failure.
• No changes in serum lipase or duodenal enzyme activities were observed.
• Gel filtration confirmed the formation of a HES-amylase complex.
• No symptoms or signs were associated with the observed hyperamylasemia.

Conclusions:

• HES infusion causes a temporary macroamylasemia due to HES-amylase complex formation.
• This phenomenon can lead to misdiagnosis of pancreatic disease.
• Awareness of this HES-induced effect is crucial for accurate clinical interpretation.