Klonoff D C
West J Med. 1980 Nov;133(5):392-407.
Macroamylase is a circulating complex of immunoglobulin linked to normal amylase in most cases. Its physical properties are heterogeneous, but its large size impairs renal filtration. Macroamylasemia usually causes hyperamylasemia and an amylase clearance:creatinine clearance (C(AM):C(CR)) ratio of less than 1 percent. Macroamylasemia occurs in 2.5 percent of hyperamylasemic patients, and 1 percent of apparently healthy subjects with normal amylase levels. It often accompanies diseases of aberrant immunity or conditions in which pancreatitis must be ruled out. This disorder should be considered in a patient with asymptomatic hyperamylasemia because its detection can obviate a prolonged diagnostic workup. The condition requires no treatment and may be transient. Macroamylasemia is one of several immunoglobulin-complexed enzyme (ICE) disorders. MacroLDemia, an ICE disorder of lactate dehydrogenase (LD), shares features with macroamylasemia. These and other ICE disorders appear to represent nonspecific dysproteinemic responses to disease.
在大多数情况下，巨淀粉酶是一种与正常淀粉酶相连的免疫球蛋白循环复合物。其物理性质具有异质性，但其大尺寸会损害肾脏滤过功能。巨淀粉酶血症通常会导致高淀粉酶血症，且淀粉酶清除率与肌酐清除率（C(AM):C(CR)）之比小于1%。巨淀粉酶血症在2.5%的高淀粉酶血症患者以及1%淀粉酶水平正常的健康受试者中出现。它常伴有异常免疫疾病或必须排除胰腺炎的情况。对于无症状高淀粉酶血症患者应考虑这种疾病，因为检测到它可以避免长时间的诊断检查。这种情况无需治疗，可能是短暂性的。巨淀粉酶血症是几种免疫球蛋白复合酶（ICE）疾病之一。乳酸脱氢酶（LD）的ICE疾病——巨LD血症与巨淀粉酶血症有共同特征。这些以及其他ICE疾病似乎代表了对疾病的非特异性异常蛋白反应。
