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Macrolipasemia is the presence of serum lipase of a large molecular size, seen occasionally in otherwise healthy individuals, but more commonly in various diseases. Lipase is able to self-polymerize and/or form complexes with other blood proteins e.g. immunoglobulins.
Epidemiological data on macrolipasemia is lacking however it is more common as healthy individuals age 2.
Macroenzymes are not uncommon on laboratory assays of human blood. Many proteins self-polymerize or form complexes with other proteins, which are normal constituents of blood, e.g. immunoglobulins, carrier molecules, etc. 2.
Serum lipase has been found complexed to immunoglobulins and alpha 2-macroglobulin (α2-MG) 2. The latter is a common carrier protein found in normal blood.
Normal non-complexed lipase is freely filtered at the renal glomerulus. In macrolipasemia the molecule is too large to be filtered by the kidney resulting in a normal urinary lipase despite being elevated in the serum.
This condition can be confused with other causes of raised serum lipase (e.g. acute pancreatitis). Macrolipasemia is accompanied by normal serum lipase and urinary lipase levels. By contradistinction, in pancreatic disease the serum amylase will usually be elevated as well 2.
Causes of macrolipasemia
Macrolipasemia can be detected occasionally in well individuals, and is more common as age increases, although rarely seen in young people. More commonly it is detected in disease states:
History and etymology
"Macro lipase" was first described in 1987 by Stein and colleagues 3.
- 1. Bode C, Riederer J, Brauner B, Bode JC. Macrolipasemia: a rare cause of persistently elevated serum lipase. (1990) The American journal of gastroenterology. 85 (4): 412-6. Pubmed
- 2. Taes YE, Louagie H, Yvergneaux JP, De Buyzere ML, De Puydt H, Delanghe JR, Lott JA. Prolonged hyperlipasemia attributable to a novel type of macrolipase. (2000) Clinical chemistry. 46 (12): 2008-13. Pubmed
- 3. Stein W, Bohner J, Bahlinger M. Macro lipase--a new member of the family of immunoglobulin-linked enzymes. (1987) Journal of clinical chemistry and clinical biochemistry. Zeitschrift fur klinische Chemie und klinische Biochemie. 25 (12): 837-43. Pubmed
- 4. Goto H, Wakui H, Komatsuda A, Imai H, Miura AB, Fujita K. Simultaneous macroamylasemia and macrolipasemia in a patient with systemic lupus erythematosus in remission. (2000) Internal medicine (Tokyo, Japan). 39 (12): 1115-8. Pubmed