Macroamylasemia in patients with celiac disease

OBJECTIVE: Macroamylasemia is considered to be rarely associated with celia c disease (CD). We have evaluated patients in whom macroamylasemia or eleva ted total amylase (TA) led to the diagnosis of CD. These cases served as a catalyst for examining the prevalence of elevated TA and macroamylase (MA) in patients with active CD. METHOD: Total amylase and MA measurements were performed in the sera of 124 celiac patients with positive antiendomysium and tissue transglutaminase t ests, in 100 patients on gluten-free diet (GFD) with negative serology test results, and in the sera of 89 healthy controls. Macroamylasemia was measu red by using the PEG precipitation method. RESULTS: Twenty-three newly diagnosed celiac patients had elevated serum am ylase levels (>2 SD above the controls). The average TA and MA levels were significantly elevated in both celiac groups. The nonprecipitated amylase l evels (pancreatic and salivary amylase fractions) were not different from t hose of the controls. Three controls (3.4%), 21 newly diagnosed celiac (16. 8%), and seven patients on CFD (7%) had significantly elevated MA activity in their sera. CONCLUSIONS: A significant percentage of the newly diagnosed patients with CD have macroamylasemia. Serum MA remained elevated in some patients on str ict GFD. In addition, in the presence of an elevated amylase or MA the poss ibility of CD should be considered. (Am J Gastroenterol 2001;96:1096-1100. (C) 2001 by Am. Coll. of Gastroenterology).