Detection of hydroxyethyl starch induced macroamylasemia: Comparison of electrophoresis and gel-permeation high-performance liquid chromatography

Electrophoretic and chromatographic characterization of macroamylasemia induced by hydroxyethyl starch (HES) was performed. HES-induced macroamylasemic sera were obtained from the patients subjected to intravenous infusion of HES solution during surgery. Macromolecular amylase was observed in the patient's sera obtained from termination of the infusion of HES to 24h post-operation by gel-permeation high-performance liquid chromatography (HPLC) analysis. However, anomalous bands were detected in the patient's sera only immediately or two hours after termination of the infusion by isoamylase electrophoretic analysis. In the samples of non-macroamylasemic serum mixed with HES solution in vitro, the anomalous pattern was observed only in the sample with volume ratio of 1:1 and/or 1:1/2. In contrast, the peak of macromolecular amylase was detected in the all samples with the ratio from 1:1/2 to 1:1/20. From the results, it was recognized that gel-permeation HPLC analysis was a more sensitive method in HES-induced macroamylasemia than isoamylase electrophoretic analysis.