TITLE:
Transient Macroamylasemia in a Severely Multiple-Handicapped Child Following the Development of Acute Bronchitis
AUTHORS:
Yoshihiko Sakurai
KEYWORDS:
Acute Respiratory Infections, Amylase-Creatinine Clearance Ratio (ACCR), Macroamylasemia, Multiple-Handicapped Child
JOURNAL NAME:
Open Journal of Pediatrics,
Vol.5 No.3,
September
4,
2015
ABSTRACT: Macroamylasemia is a condition of elevated serum amylase levels in which
normal serum amylase form a complex with high molecular weight proteins such as
immunoglobulins. This is a case report on a patient with macroamylasemia
following acute asthmatic bronchitis. A 5-year-old male with cerebral palsy and
developmental retardation was admitted to our hospital because of high fever
and severe cough. Treatment of the respiratory symptoms provided symptomatic
improvement, but the serum amylase levels became suddenly elevated. Although
acute pancreatitis associated with respiratory infection was initially
suspected, a predominant salivary isoamylase, normal serum lipase level, low
urine amylase level, and low
amylase-creatinine clearance ratio (ACCR) (0.58%) indicated
macroamylasemia. The serum amylase level decreased, and the ACCR increased
within normal range 2 weeks after discharge. Both of these indicators have been
within normal range over the past year. Transient macroamylasemia can be
misdiagnosed as acute pancreatitis, especially in a severely
multiple-handicapped child who is unable to complain. The ACCR is useful in the
diagnosis of macroamylasemia.