Work

A rare case of macroamylasemia in a patient with SARS-CoV-2 infection

Year: 2025

Type: article

Abstract: BACKGROUND: Macroamylasemia is a rare condition affecting 0.5-1.5% of the population. Macroamylasemia should be suspected in a patient with a high serum alpha-amylase level without an elevation in the urine alpha-amylase level. Serum amylase binds with other serum proteins like immunoglobulins A (92%), immunoglobulins G (< 30%), and others (< 5%), forming macromolecular complexes that weigh more than 400 KDa. Nephrones are unable to secrete these macromolecules into the urine due to their large size, which causes the accumulation of these macromolecules in the serum. Patients with COVID-19 during seroconversion develop higher concentrations of SARS-CoV-2-specific immunoglobulins and different plasma proteins, which can bind with the alpha amylase molecules and cause macroamylasemia. CASE PRESENTATION: In this case report, we report about a 70-year-old hypertensive and asthmatic patient who was under inward treatment for mild COVID-19. He complained ofburning epigastric pain for one day and his elevated serum amylase level persisted months after the initial presentation. He underwent extensive investigations to exclude acute pancreatitis and other causes of high amylase levels. His amylase creatinine clearance ratio was 0.2%, his pre- polyethylene glycol(PEG) amylase concentration was 644 U/L, and his post-PEG amylase concentration was 10 U/L with a very low post-PEG recovery (1.55%). He was diagnosed with macroamylasemia.

Source: BMC Infectious Diseases

DOI: 10.1186/s12879-025-10642-x

Authors: Tilan Aponso, W. M. D. A. S. Wanninayake, N. M. M. Nawarathne

Institution: National Hospital of Sri Lanka

Language: English

Topic: Clinical Laboratory Practices and Quality Control

Subfield: Physiology

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $3,090