Adil Coşkun MD, Adil COŞKUN, Deniz ÇETİN, M. Hadi YAŞA, A. Önder KARAOĞLU

Hiperamilazeminin Nadir Bir Nedeni: Makroamilazemi

Artmış serum amilaz aktivitesi akut pankreatit ve tükrük bezi enflamasyonunda sıklıkla görülmekle birlikte nadir olarak, tedavi gerektirmeyen benign bir fenomen olan makroamilazemide de görülmektedir. Hiperamilazemi karın ağrısı ile başvuran hastalarda zaman zaman tanısal karışıklığa yol açabilen bir laboratuvar bulgusudur. Serum amilaz düzeyi yüksekliği ve karın ağrısı, makroamilazemik hastaların yanlış akut pankreatit tanısı almalarına yol açabilir. Karın ağrısı ve hiperamilazemisi olan ancak pankreatiti destekleyen görüntüleme bulgusu olmayan hastalarda makroamilazemi de akılda bulundurulmalıdır. Burada karın ağrısı ve kalıcı amilaz yüksekliği ile başvuran makroamilazemili bir olguyu sunmaktayız. Hastanın şikayeti olmadan, üç ay sonra poliklinik takibinde lipaz değeri normal iken amilaz yüksekliği (450 U/L) devam etmekteydi.

A Rare Cause of Hyperamylasemia: Macroamylasemia

Elevated serum amylase activity is commonly seen in acute pancreatitis and salivary gland inflammation, but also rarely seen in a benign phenomenon, macroamylasemia, that does not require treatment. Hyperamylasemia is a laboratory finding that may cause diagnostic failure occasionally in patients presenting with abdominal pain. Elevated serum amylase levels and abdominal pain may lead to misdiagnosis as acute pancreatitis in macroamylasemic patients. Macroamylasemia should be considered in patients with abdominal pain and hyperamylasemia but without imaging findings of pancreatitis. Here, we present a patient with macroamylasemia who had abdominal pain and persistent hyperamylasemia. The patient had no complaints but persisting hyperamylasemia (450 U/L) and normal lipase activity at the follow-up outpatient visit three months later.

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