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Hydroxyethyl starch-induced macroamylasemia

H Köhler, W Kirch, H J Horstmann

    International Journal of Clinical Pharmacology and Biopharmacy
    |September 1, 1977
    PubMed
    Summary
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    Infusion of hydroxyethyl starch (HES) can increase serum amylase levels, potentially due to a HES-amylase complex formation. This temporary increase in amylase showed no associated clinical symptoms in patients.

    Area of Science:

    • Biochemistry
    • Pharmacology
    • Clinical Medicine

    Background:

    • Hydroxyethyl starch (HES) is a colloid used for plasma volume expansion.
    • Elevated serum amylase can indicate various medical conditions, but its cause needs careful evaluation.

    Purpose of the Study:

    • To investigate the effect of hydroxyethyl starch (HES) infusion on serum amylase levels.
    • To determine the mechanism behind any observed changes in serum amylase.
    • To assess the clinical significance of HES-induced hyperamylasemia.

    Main Methods:

    • Administration of 500 ml of 6% hydroxyethyl starch (HES) solution to patients.
    • Monitoring of serum amylase levels before and after HES infusion.
    • Analysis of the molecular characteristics of HES-amylase interactions.

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    Main Results:

    • All patients exhibited an increase in serum amylase post-HES infusion, often doubling baseline values.
    • Hyperamylasemia was attributed to the formation of a stable, high-molecular-weight hydroxyethyl starch-amylase complex.
    • No clinical signs or symptoms were associated with the observed hyperamylasemia in any patient.

    Conclusions:

    • Hydroxyethyl starch (HES) administration transiently elevates serum amylase levels.
    • The elevated amylase is a biochemical finding resulting from complex formation, not indicative of pancreatic disease.
    • Clinicians should be aware of this phenomenon to avoid misinterpretation of amylase levels after HES administration.