Determination of recovery % reference intervals for ck, ldh, ast, amylase with polyethyleneglycol precipitation and ultrafiltration methods used for macroenzyme dedection and supporting the macroenzyme diagnosis via different methods

Mehmet Çingirt

Determination of recovery % reference intervals for ck, ldh, ast, amylase with polyethyleneglycol precipitation and ultrafiltration methods used for macroenzyme dedection and supporting the macroenzyme diagnosis via different methods

Thesis Type: Expertise In Medicine

Institution Of The Thesis: Gazi University, Turkey

Approval Date: 2016

Thesis Language: Turkish

Student: Mehmet Çingirt

Supervisor: ÖZLEM GÜLBAHAR

Abstract:

Macroenzymes have higher molecular weights than normal enzyme forms. Clearance of macroenzymes are much more slowly than usual enzymes, so that they accumulate in the plasma and may cause measumerent of higher enzyme activities. Not thinking of macroenzymes as a cause of increased enzyme levels or lacking the diagnosis of macroenzyme elevation can cause unnecessary , expensive and even invasive procedures. From this perspective unexplained high enzyme levels or suspected macroenzyme elevation must be recognised. In literature there are several % recovery reference intervals established with PEG precipitation method for amylase, AST, CK and LDH. Lesser publication and data exists for detecting macroenzymes with ultrafiltration method. Besides in some of these publications reference intervals were determined for healthy people whereas the others in people who had high enzyme levels. In this thesis reference intervals are established for AST, amylase, LDH, CK with two different methods mentioned before for both healty population and people have high levels of enzyme activities. The reference intervals established for amylase, AST, CK, LDH in healthy people via PEG method are 53-78, 37-81, 53-91, 33-61 respectively; for the people have high enzyme levels intervals are 44-79, 32-75, 45-94 and 28-63 respectively. The reference intervals established for amylase, AST, CK, LDH in healthy people via ultrafiltration method are 61-104, 34-77, 38-78, 27-54 respectively; for the people have high enzyme levels intervals are 56-119, 30-78, 37-78, 25-50 and 28-63 respectively. Lower limits of reference intervals detected decreased for all enzyme activities in people who have high enzyme levels. Avoiding of falsely positive results we decided to use referance intervals established for the people who have high enzyme levels. However for ultrafiltration method more research need to be done. Detected with PEG precipitation method and ultrafiltration method, 3 macroCK and 3 macroLDH patients confirmed with electrophoresis method; 2 macroamylase patients confirmed with amylase/creatinin ratios.