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An adolescent admitted to hospital because of an obvious convulsion seizure presented with a high level of serum macroaspartate aminotransferase. This macroaspartate aminotransferase was discovered by chance when blood tests were made.Macroaspartate aminotransferase is a persistent, benign phenomenon, probably not congenital, discovered either in healthy patients, or in adults suffering from malignancies or autoimmune diseases. Macroenzymes have been identified as a cause of benign increase in a number of serum enzymes, like macroamylase serum levels. The macroenzyme is often an immunoglobulin G-complexed enzyme.It is important for clinicians to be aware of their existence in order to avoid unnecessary procedures. It is important that the patient is informed of the macroaspartate aminotransferase and that the same is stated in his health record.

Orbital inflammatory lesions may be due to infection, neoplasia, systemic disease such as sarcoidosis or be idiopathic.A 13 year-old boy had uveitis and symptoms of unilateral periglobular orbital inflammation, confirmed by computed tomography. Infection and neoplasia were excluded. The serum angiotensin-converting enzyme level (ACE) was normal. Steroids were effective but three recurrences occurred with bilateralisation of the lesion. Serum ACE level increased making sarcoidosis probable. Moreover renal lesion were later found. Outcome was good with a prolonged steroid administration for ten months.Sarcoidosis may be revealed by an orbital inflammatory lesion. Steroids are necessary to prevent ocular functional complications.