From the Guidelines
Elevated lysozyme levels in blood are most commonly associated with leukemia, particularly acute myeloid leukemia (AML) and chronic myeloid leukemia (CML), as well as sarcoidosis, a condition characterized by inflammatory granulomas. The causes of elevated lysozyme in blood can be multifaceted, involving various medical conditions. Some of the key conditions include:
- Leukemia, specifically acute myeloid leukemia (AML) and chronic myeloid leukemia (CML), where abnormal white blood cells produce excessive lysozyme 1
- Sarcoidosis, which often shows increased lysozyme levels as activated macrophages release this enzyme 1
- Tuberculosis and other chronic infections, which can elevate lysozyme as part of the immune response
- Inflammatory bowel diseases like Crohn's disease, which may show higher lysozyme levels due to intestinal inflammation
- Renal dysfunction, leading to elevated lysozyme because the kidneys normally filter this enzyme, and impaired function causes accumulation
- Some autoimmune disorders and certain types of lymphoma, which may also increase blood lysozyme levels Lysozyme is an enzyme that helps fight bacterial infections by breaking down bacterial cell walls, so its elevation generally indicates activation of the immune system or proliferation of cells that produce it. Monitoring lysozyme levels can help track disease progression and treatment response in these conditions. It's worth noting that while other conditions such as Chediak-Higashi syndrome 1 and tumor lysis syndrome 1 can also affect lysozyme levels, the most recent and highest quality evidence points towards leukemia and sarcoidosis as primary causes of elevated lysozyme in blood 1.
From the Research
Causes of Elevated Lysozyme in Blood
- Elevated lysozyme levels can be associated with various conditions, including:
- Acute myelogenous leukemia with eosinophilia, as reported in a case study 2
- Acute myeloid leukemia, particularly in cases of acute myelomonocytic leukemia (FAB M4) and acute myeloblastic leukemia with maturation (FAB M2) 3
- Desquamative interstitial pneumonia (DIP), with elevated serum levels of lysozyme observed in four out of five cases studied 4
- Sarcoidosis, where serum lysozyme is used as a marker of disease activity, with a sensitivity of 79.1% 5
- Elevated leukocyte count, including neutrophil and monocyte counts, can also be a harbinger of increased systemic inflammation and subclinical disease, which may be related to elevated lysozyme levels 6
Conditions Associated with Elevated Lysozyme
- Acute myeloid leukemia (AML)
- Desquamative interstitial pneumonia (DIP)
- Sarcoidosis
- Systemic inflammation and subclinical disease
Laboratory Tests and Markers
- Serum lysozyme level
- Urine lysozyme level
- Leukocyte count, including neutrophil and monocyte counts
- Angiotensin-converting enzyme (ACE) level
- C-reactive protein and interleukin 6 levels, as markers of systemic inflammation 6