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Macroamylasaemia after treatment with hydroxyethyl starch
Author(s) -
KOHLER H.,
KIRCH W.,
WEIHRAUCH T. R.,
PRELLWITZ W.,
HORSTMANN H. J.
Publication year - 1977
Publication title -
european journal of clinical investigation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.164
H-Index - 107
eISSN - 1365-2362
pISSN - 0014-2972
DOI - 10.1111/j.1365-2362.1977.tb01599.x
Subject(s) - hydroxyethyl starch , starch , chemistry , medicine , food science , biochemistry
. After infusion of 500 ml of 6% hydroxyethyl starch into fifty‐four patients an increase of serum amylase was observed which in fifty‐one cases exceeded the upper limit of normal (190 U/l). In most cases serum amylase reached twice the basal value. Renal function influenced the duration of the increase in serum amylase, but not the maximum increase (201±15 U/l; mean±SEM). In patients with advanced renal failure (glomerular filtration rate (GFR) = 2–10 ml/min) serum amylase was still markedly elevated after 72 h (298±24 U/l; mean±SEM). In patients with normal renal function (GFR>90 ml/min) serum amylase decreased to 183±40 U/l (mean±SEM) within 72 h without reaching basal values. After infusion of HES no changes were observed in serum lipase or in amylase or lipase activities in duodenal secretion. Amylase excretion in the urine decreased. The assumption of a macroamylasaemia caused by formation of an HES‐amylase complex was confirmed by gel filtration. The elimination from plasma of this high molecular enzyme‐substrate complex is slow and causes hyperamylasaemia. In no case was the macroamylasaemia associated with signs or symptoms. An awareness of this causal relationship seems to be important, to avoid the erroneous diagnosis of a pancreatic disease.