{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,15]],"date-time":"2025-08-15T01:02:20Z","timestamp":1755219740760,"version":"3.43.0"},"reference-count":12,"publisher":"Wiley","issue":"15","license":[{"start":{"date-parts":[[2025,6,24]],"date-time":"2025-06-24T00:00:00Z","timestamp":1750723200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Laboratory Analysis"],"published-print":{"date-parts":[[2025,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Persistent elevation of aspartate aminotransferase (AST) is commonly indicative of liver injury or disease, but isolated AST elevation without concurrent alanine aminotransferase (ALT) increase is rare and difficult to diagnose. While AST is non\u2010specific and found in various tissues, its isolated elevation is due to less common conditions, such as macro\u2010AST, where AST binds with immunoglobulins creating a high\u2010molecular\u2010weight complex that affects serum activity.<\/jats:p><\/jats:sec><jats:sec><jats:title>Case Description<\/jats:title><jats:p>A 68\u2010year\u2010old female with a history of high\u2010grade serous ovarian cancer (HGSOC) who had persistent isolated AST elevation for several years. Evaluations including physical exams, imaging, and routine liver function tests showed no evidence of hepatic or muscular disease. The polyethylene glycol (PEG) precipitation significantly reduced serum AST activity, confirming the presence of the macro\u2010enzyme form of AST (macro\u2010AST).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>This case highlights the rare and novel occurrence of macro\u2010AST in a patient with ovarian cancer. It emphasizes the importance of considering macro\u2010AST in the differential diagnosis of isolated AST elevation, particularly in patients without clear evidence of liver or muscular disease. Recognizing this benign condition can prevent unnecessary diagnostic procedures and anxiety.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jcla.70072","type":"journal-article","created":{"date-parts":[[2025,6,24]],"date-time":"2025-06-24T08:19:40Z","timestamp":1750753180000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Persistent <scp>AST<\/scp> Elevation in a Patient With Ovarian Cancer: A Rare Diagnostic Challenge"],"prefix":"10.1002","volume":"39","author":[{"given":"Lechuang","family":"Chen","sequence":"first","affiliation":[{"name":"Department of Laboratory Medicine The University of Texas MD Anderson Cancer Center  Houston Texas USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yu","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine The University of Texas MD Anderson Cancer Center  Houston Texas USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1433-9860","authenticated-orcid":false,"given":"Qing H.","family":"Meng","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine The University of Texas MD Anderson Cancer Center  Houston Texas USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,6,24]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(99)00219-6"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.4065\/71.11.1089"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.21037\/jlpm-20-93"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0253070"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0025-6196(12)65219-7"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10620-011-1575-4"},{"issue":"6","key":"e_1_2_7_8_1","article-title":"Macro\u2010Aspartate Aminotransferase: Misleading Finding in a Patient With Non\u2010Alcoholic Fatty Liver Disease","volume":"11","author":"Sharma N.","year":"2019","journal-title":"Cureus"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.dld.2017.12.009"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1373\/clinchem.2008.120782"},{"issue":"4","key":"e_1_2_7_11_1","article-title":"Macro\u2010Aspartate Aminotransferase: A Benign Cause of Abnormal Laboratory Findings","volume":"14","author":"Reddy N.","year":"2022","journal-title":"Cureus"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpeds.2008.11.010"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1097\/00042737-200312000-00018"}],"container-title":["Journal of Clinical Laboratory Analysis"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jcla.70072","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,7]],"date-time":"2025-08-07T08:01:03Z","timestamp":1754553663000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/jcla.70072"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,6,24]]},"references-count":12,"journal-issue":{"issue":"15","published-print":{"date-parts":[[2025,8]]}},"alternative-id":["10.1002\/jcla.70072"],"URL":"https:\/\/doi.org\/10.1002\/jcla.70072","archive":["Portico"],"relation":{},"ISSN":["0887-8013","1098-2825"],"issn-type":[{"type":"print","value":"0887-8013"},{"type":"electronic","value":"1098-2825"}],"subject":[],"published":{"date-parts":[[2025,6,24]]},"assertion":[{"value":"2025-03-20","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-06-13","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-06-24","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70072"}}