From the ARUP Institute for Clinical and Experimental Pathology, Salt Lake City, UT;
SUNY, Stony Brook School of Medicine, Stony Brook, NY;
Am J Clin Pathol. 2014 Aug;142(2):266-8. doi: 10.1309/AJCPWA9QHR9WHPNA.
Multiple immunoglobulin-bound enzymes (macroenzymes) are reported for the first time in an individual with AIDS. Possible causes and suitable methods of detection are addressed.
An asymptomatic man with a history of AIDS with hypergammaglobulinemia and elevated creatine kinase, amylase, and liver enzyme concentrations was evaluated before enrollment in a clinical trial. Macroenzymes were considered a possible source of these elevated concentrations.
Polyethylene glycol (PEG) precipitation and ultrafiltration (UF) were used to evaluate the presence of seven macroenzymes. PEG results suggested the presence of six of seven macroenzymes tested, while UF revealed three. UF results supported the clinical presentation.
A previous report shows that in cases of excess immunoglobulin, PEG coprecipitates monomeric enzymes along with serum globulins, causing false-positive reporting of macroenzymes. This may explain the discrepancy between PEG and UF results in the presence of hypergammaglobulinemia, making UF a better method of detection in these circumstances.
首次在艾滋病患者中报告了多种免疫球蛋白结合酶（巨酶）。探讨了其可能的原因和合适的检测方法。
在一名无症状的艾滋病男性患者入组临床试验前，该患者具有高丙种球蛋白血症和肌酸激酶、淀粉酶和肝酶浓度升高的病史。巨酶被认为是这些升高浓度的可能来源。
使用聚乙二醇（PEG）沉淀和超滤（UF）来评估七种巨酶的存在。PEG 结果表明存在测试的七种巨酶中的六种，而 UF 则显示了三种。UF 的结果支持临床表现。
之前的一份报告显示，在免疫球蛋白过多的情况下，PEG 会与血清球蛋白共沉淀单体酶，导致巨酶的假阳性报告。这可能解释了高丙种球蛋白血症时 PEG 和 UF 结果之间的差异，使 UF 成为这种情况下更好的检测方法。
