title: [Macro-AST and myeloma: An incidental association?]
abstract: BACKGROUND
  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.
  
  
  METHODS
  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.
  
  
  CONCLUSIONS
  This is the first report demonstrating a clear link between macro-AST and a monoclonal gammopathy.
authors.affiliation: Service de gastro-entérologie et de médecine interne, centre hospitalier Gabriel-Martin, 38, rue Labourdonnais, 97460 Saint-Paul, Réunion. Electronic address: roussinc@yahoo.fr.
authors.forename: C
authors.initials: C
authors.lastname: Lartigau-Roussin
authors.affiliation: Laboratoire de biochimie des enzymes et des protéines, DBTP, institut de biologie et pathologie, CHU Grenoble Alpes, 38043 Grenoble, France.
authors.forename: M H
authors.initials: MH
authors.lastname: Paclet
authors.affiliation: Service de gastro-entérologie et de médecine interne, centre hospitalier Gabriel-Martin, 38, rue Labourdonnais, 97460 Saint-Paul, Réunion.
authors.forename: H
authors.initials: H
authors.lastname: Audin
authors.affiliation: Laboratoire de biochimie des enzymes et des protéines, DBTP, institut de biologie et pathologie, CHU Grenoble Alpes, 38043 Grenoble, France.
authors.forename: B
authors.initials: B
authors.lastname: Toussaint
authors.affiliation: Service d'hématologie, CHU La Réunion site Félix-Guyon, allée des Topazes, CS11021, 97400 Saint-Denis, Réunion.
authors.forename: T
authors.initials: T
authors.lastname: Henni
authors.affiliation: Service de médecine interne, CHU La Réunion site Félix-Guyon, allée des Topazes, CS11021, 97400 Saint-Denis, Réunion.
authors.forename: L
authors.initials: L
authors.lastname: Raffray
mesh_terms: D001219:Aspartate Aminotransferases / Q000097:blood*; D005260:Female; D006801:Humans; D008107:Liver Diseases / Q000097:blood / Q000150:complications* / Q000175:diagnosis*; D008875:Middle Aged; D009101:Multiple Myeloma / Q000097:blood / Q000150:complications* / Q000175:diagnosis*; D010265:Paraproteinemias / Q000097:blood / Q000150:complications / Q000175:diagnosis; D015854:Up-Regulation
chemical_list: D001219:Aspartate Aminotransferases
keywords: Antigen-antibody complex; Aspartate aminotransferase; Aspartate aminotransférase; Complexe antigène-anticorps; Immunoglobulin; Immunoglobuline monoclonale; Macro-ASAT; Macro-AST; Multiple myeloma; Myélome multiple