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Nadour Z, Rosenbaum B, Blons H, Loriot MA, Paul JL, Pallet N. [Clinical, biochemical and epidemiological features of macro-AST preceding inflammatory bowel disease diagnosis by several years]. Rev Med Interne 2023; 44:259-262. [PMID: 36958982 DOI: 10.1016/j.revmed.2023.03.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Accepted: 03/05/2023] [Indexed: 03/25/2023]
Abstract
INTRODUCTION An isolated elevation of aspartate aminotransferase (AST) is a diagnostic issue. Macro-aspartate aminotransferase (macro-AST) corresponds to the formation of complexes between AST and immunoglobulins. CASE REPORT We report the case of a patient with macro-AST identified several years before the onset of inflammatory bowel disease (IBD). A 6-year retrospective analysis in our laboratory identified only one case out of 42 540 adult patients. CONCLUSION The objective of this work is to increase awareness of this benign disorder among clinicians and biologists, as well as to aid in prescribing only the required tests.
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Affiliation(s)
- Z Nadour
- Service de biochimie, hôpital européen Georges-Pompidou, assistance publique-hôpitaux de Paris (AP-HP), 75013 Paris, France.
| | - B Rosenbaum
- Service de gastroentérologie et endoscopie digestive, hôpital européen Georges-Pompidou, assistance publique-hôpitaux de Paris (AP-HP), 75013 Paris, France
| | - H Blons
- Service de biochimie, hôpital européen Georges-Pompidou, assistance publique-hôpitaux de Paris (AP-HP), 75013 Paris, France
| | - M A Loriot
- Service de biochimie, hôpital européen Georges-Pompidou, assistance publique-hôpitaux de Paris (AP-HP), 75013 Paris, France
| | - J-L Paul
- Service de biochimie, hôpital européen Georges-Pompidou, assistance publique-hôpitaux de Paris (AP-HP), 75013 Paris, France
| | - N Pallet
- Service de biochimie, hôpital européen Georges-Pompidou, assistance publique-hôpitaux de Paris (AP-HP), 75013 Paris, France
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Mingju H, Minyu W, Xiaoxiao G, Sumei L, Jianping M, Wanshan M. Macro-aspartate aminotransferase syndrome: a case report. ACTA ACUST UNITED AC 2020; 58:e96-e99. [PMID: 32112698 DOI: 10.1515/cclm-2019-0618] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2019] [Accepted: 07/22/2019] [Indexed: 12/27/2022]
Affiliation(s)
- Hao Mingju
- Department of Laboratory Medicine, Shandong Provincial Qianfoshan Hospital , Shandong University , Jinan , P.R. China
| | - Wang Minyu
- Department of Laboratory Medicine, Shandong Provincial Qianfoshan Hospital , Shandong University , Jinan , P.R. China
| | - Ge Xiaoxiao
- Department of Laboratory Medicine, Shandong Provincial Qianfoshan Hospital , Shandong University , Jinan , P.R. China
| | - Lu Sumei
- Department of Laboratory Medicine, Shandong Provincial Qianfoshan Hospital , Shandong University , Jinan , P.R. China
| | - Ma Jianping
- Department of Laboratory Medicine, Shandong Provincial Qianfoshan Hospital , Shandong University , Jinan , P.R. China
| | - Ma Wanshan
- Department of Laboratory Medicine, Shandong Provincial Qianfoshan Hospital , Shandong University , Jinan , P.R. China
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Kulecka M, Wierzbicka A, Paziewska A, Mikula M, Habior A, Janczyk W, Dabrowska M, Karczmarski J, Lazniewski M, Ginalski K, Czlonkowska A, Socha P, Ostrowski J. A heterozygous mutation in GOT1 is associated with familial macro-aspartate aminotransferase. J Hepatol 2017; 67:1026-1030. [PMID: 28716744 DOI: 10.1016/j.jhep.2017.07.003] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2017] [Revised: 06/16/2017] [Accepted: 07/01/2017] [Indexed: 12/20/2022]
Abstract
BACKGROUND & AIMS Macro-aspartate aminotransferase (macro-AST) manifests as a persistent elevation of AST levels, because of association of the protein with immunoglobulins in the circulation. Macro-AST is a rare, benign condition without a previously confirmed genetic basis. METHODS Whole exome sequencing (WES)-based screening was performed on 32 participants with suspected familial macro-AST, while validation of variants was performed on an extended cohort of 92 probands and 1,644 healthy controls using Taqman genotyping. RESULTS A missense variant (p.Gln208Glu, rs374966349) in glutamate oxaloacetate transaminase 1 (GOT1) was found, as a putative causal variant predisposing to familial macro-AST. The GOT1 p.Gln208Glu mutation was detected in 50 (54.3%) of 92 probands from 20 of 29 (69%) families, while its prevalence in healthy controls was only 0.18%. In silico analysis demonstrated that the amino acid at this position is not conserved among different species and that, functionally, a negatively charged glutamate on the GOT1 surface could strongly anchor serum immunoglobulins. CONCLUSIONS Our data highlight that testing for the p.Gln208Glu genetic variant may be useful in diagnosis of macro-AST. LAY SUMMARY Higher than normal levels of aspartate aminotransferase (AST) in the bloodstream may be a sign of a health problem. Individuals with macro-AST have elevated blood AST levels, without ongoing disease and often undergo unnecessary medical tests before the diagnosis of macro-AST is established. We found a genetic variant in the GOT1 gene associated with macro-AST. Genetic testing for this variant may aid diagnosis of macro-AST.
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Affiliation(s)
- Maria Kulecka
- Department of Gastroenterology and Hepatology, Medical Center for Postgraduate Education, Warsaw 01-813, Poland
| | - Aldona Wierzbicka
- Department of Biochemistry, Radioimmunology and Experimental Medicine, Children's Memorial Health Institute, Warsaw 04-730, Poland
| | - Agnieszka Paziewska
- Department of Gastroenterology and Hepatology, Medical Center for Postgraduate Education, Warsaw 01-813, Poland
| | - Michal Mikula
- Department of Genetics, Cancer Center-Institute, Warsaw 02-781, Poland
| | - Andrzej Habior
- Department of Gastroenterology and Hepatology, Medical Center for Postgraduate Education, Warsaw 01-813, Poland
| | - Wojciech Janczyk
- Department of Gastroenterology, Hepatology and Feeding Disorders, Children's Memorial Health Institute, Warsaw 04-730, Poland
| | | | - Jakub Karczmarski
- Department of Genetics, Cancer Center-Institute, Warsaw 02-781, Poland
| | - Michal Lazniewski
- Laboratory of Bioinformatics and Systems Biology, Centre of New Technologies, University of Warsaw, Warsaw 02-089, Poland; Department of Physical Chemistry, Faculty of Pharmacy, Medical University of Warsaw, Warsaw 02-097, Poland
| | - Krzysztof Ginalski
- Laboratory of Bioinformatics and Systems Biology, Centre of New Technologies, University of Warsaw, Warsaw 02-089, Poland
| | - Anna Czlonkowska
- Department of Neurology, Institute of Psychiatry and Neurology, Warsaw, Poland
| | - Piotr Socha
- Department of Gastroenterology, Hepatology and Feeding Disorders, Children's Memorial Health Institute, Warsaw 04-730, Poland.
| | - Jerzy Ostrowski
- Department of Gastroenterology and Hepatology, Medical Center for Postgraduate Education, Warsaw 01-813, Poland; Department of Genetics, Cancer Center-Institute, Warsaw 02-781, Poland.
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Lartigau-Roussin C, Paclet MH, Audin H, Toussaint B, Henni T, Raffray L. [Macro-AST and myeloma: An incidental association?]. Rev Med Interne 2016; 38:210-213. [PMID: 27745940 DOI: 10.1016/j.revmed.2016.05.015] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2015] [Revised: 02/29/2016] [Accepted: 05/28/2016] [Indexed: 01/18/2023]
Abstract
INTRODUCTION Macro-AST is recognized as a classical aetiology of isolated and persistent increase of serum aspartate aminotransferase (AST) levels. Macro-AST are high molecular weight complexes associating AST and a macromolecule, often an immunoglobulin. Although those macroenzymes of unknown pathogenesis are usually non-pathogenic, association with several diseases, including autoimmune diseases and liver diseases has been described. CASE REPORT We report here the case of a 45-year-old patient with previously normal liver enzymes in whom an AST elevation and an IgA monoclonal gammopathy were discovered concomitantly. Following the diagnosis of multiple myeloma, we could evidence in the patient's serum a complex between AST and the monoclonal IgA. AST levels course followed closely the progression of monoclonal gammopathy. CONCLUSION This is the first report demonstrating a clear link between macro-AST and a monoclonal gammopathy.
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Affiliation(s)
- C Lartigau-Roussin
- Service de gastro-entérologie et de médecine interne, centre hospitalier Gabriel-Martin, 38, rue Labourdonnais, 97460 Saint-Paul, Réunion.
| | - M H Paclet
- Laboratoire de biochimie des enzymes et des protéines, DBTP, institut de biologie et pathologie, CHU Grenoble Alpes, 38043 Grenoble, France
| | - H Audin
- Service de gastro-entérologie et de médecine interne, centre hospitalier Gabriel-Martin, 38, rue Labourdonnais, 97460 Saint-Paul, Réunion
| | - B Toussaint
- Laboratoire de biochimie des enzymes et des protéines, DBTP, institut de biologie et pathologie, CHU Grenoble Alpes, 38043 Grenoble, France
| | - T Henni
- Service d'hématologie, CHU La Réunion site Félix-Guyon, allée des Topazes, CS11021, 97400 Saint-Denis, Réunion
| | - L Raffray
- Service de médecine interne, CHU La Réunion site Félix-Guyon, allée des Topazes, CS11021, 97400 Saint-Denis, Réunion
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Effect of untreated, HCl treated or copper and iodine supplemented high glucosinolate mustard (Brassica juncea) meal on nutrient utilization, liver enzymes, thyroid hormones and growth of calves. Anim Feed Sci Technol 2001. [DOI: 10.1016/s0377-8401(01)00243-7] [Citation(s) in RCA: 21] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Onifade A, Obiyan R, Onipede E, Adejumo D, Abu O, Babatunde G. Assessment of the effects of supplementing rabbit diets with a culture of Saccharomyces cerevisiae using growth performance, blood composition and clinical enzyme activities. Anim Feed Sci Technol 1999. [DOI: 10.1016/s0377-8401(98)00244-2] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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