RT Book, Section
A1 Kemp, Walter L.
A1 Burns, Dennis K.
A1 Brown, Travis G.
SR Print(0)
ID 57054240
T1 Chapter 15. Pathology of the Liver, Gallbladder, and Pancreas
T2 Pathology: The Big Picture
YR 2008
FD 2008
PB The McGraw-Hill Companies
PP New York, NY
SN 978-0-07-147748-2
LK accessmedicine.mhmedical.com/content.aspx?aid=57054240
RD 2024/04/18
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.