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June 11, 1973

Macroamylasemia: Value of Rapid Diagnosis

JAMA. 1973;224(11):1529. doi:10.1001/jama.1973.03220250051019

To the Editor.—  Macroamylasemia has been recently described1 as a cause of persistently elevated serum amylase levels. This elevation occurs without pancreatitis or renal disease due to a macromolecular complex too large to be filtered at the glomerulus. Levitt et al2 suggested that widely available techniques for amylase determination could be used to diagnose macroamylasemia without resorting to complex biochemical tests. This case report illustrates how the use of simple amylase tests to presumptively diagnose macroamylasemia may be very helpful in managing acute intraabdominal problems.

Report of a Case.—  A 53-year-old black seaman gave a history of three days of crampy, epigastric, and midabdominal pain radiating to the back. He was acutely ill with a blood pressure reading 158/84 mm Hg, pulse rate of 92, and a temperature of 36.6 C. The abnormal physical findings were high pitched bowel sounds, right upper quadrant tenderness, and a palpable splenic