Although serum amylase was elevated, the clinicians suspected macroamylase and ordered gel filtration to confirm whether the enzyme formed a high-molecular-weight complex bound to a globulin and therefore was not being excreted in the urine.

Clinicians must distinguish macroamylases from other causes of elevated serum amylase to avoid unnecessary investigations.

The clinician considered macroamylasemia when amylase levels remained high despite no signs of pancreatitis.