TY - CHAP M1 - Book, Section TI - Chapter 15. Pathology of the Liver, Gallbladder, and Pancreas A1 - Kemp, Walter L. A1 - Burns, Dennis K. A1 - Brown, Travis G. Y1 - 2008 N1 - T2 - Pathology: The Big Picture AB - Abnormalities in laboratory tests are frequently the first or only sign of liver disease, and the pattern of abnormality is often suggestive of the underlying disease process. Gamma-glutamyltransferase (GGT) is particularly sensitive for liver disease. If the level of GGT is normal, there is only a 1–2% chance of liver disease. The levels of aspartate aminotransferase (AST) and alanine aminotransferase (ALT) are also very useful for the diagnosis of liver disease. An AST > 3000 U/L suggests a severe hypotensive episode causing centrilobular necrosis, a toxic injury such as acetaminophen overdose, or acute viral hepatitis. On the other hand, chronic diseases of the liver such as alcoholic liver disease and chronic viral hepatitis are typically associated with smaller elevations of transaminases, in the 100–300 U/L range. Elevated ALT and AST with an AST/ALT ratio > 2:1 is classically associated with alcoholic hepatitis. Elevated alkaline phosphatase (ALP) can be seen in both liver and bone disease, whereas a concomitant elevation of ALP and GGT is consistent with cholestatic liver disease. SN - PB - The McGraw-Hill Companies CY - New York, NY Y2 - 2024/03/28 UR - accessmedicine.mhmedical.com/content.aspx?aid=57054240 ER -