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[Macroenzymes: an interesting laboratory finding, without clinical relevance]
Harefuah
|January 7, 1998
Summary
Macroenzymes are enzyme complexes that can elevate serum enzyme levels, mimicking disease. Recognizing these benign macroenzymes, like immunoglobulin G complexes, prevents unnecessary medical tests and procedures.
Area of Science:
- Clinical Biochemistry
- Immunology
Background:
- Macroenzymes are enzyme-protein complexes with increased molecular weight and prolonged plasma half-life.
- Their presence is indicated by elevated serum enzyme activity without associated clinical symptoms.
Observation:
- This study reports two patients with markedly elevated lactate dehydrogenase (LDH) and creatine kinase (CK) levels.
- These elevations were attributed to the formation of macroenzymes involving immunoglobulin G.
Findings:
- One patient presented with an LDH of 4500 u/L but was otherwise asymptomatic.
- The second patient showed elevated CK without any signs of ischemic heart disease.
Implications:
- Awareness of macroenzyme formation is crucial for accurate diagnosis.
- Recognizing macroenzymes can prevent misdiagnosis, leading to unnecessary investigations and procedures.