Enzyme Main Source Other Causes of increase Causes of decrease Main disease or More specific

source application diagnosis

Erythrocyte -Prostatic Causes
Plts Metastatic Carcinoma of prostate Metastatic Carcinoma Measurements of
Prostate Liver -Non-Prostatic causes of prostate Prostate specific
Acid Phosphatase Spleen Hemolysis Antigen
Bone disease ( Peget's )
Metastatic Carcinoma of breast
Liver Normally:
Hepatobiliary Bone Period of active bone growth Inherited Condition -Determining of
Alkaline tree Placenta ( infant & puberty ) Hypophosphatasia Hepatobiliary & Bone isoenzyme
Phosphatase Kidney Pregnancy ( Second & third trimesters ) x2 By Defective bone diseases -estimation of other
Osteoblast Intestine Pathologically: Calcification enzyme ( gamma-
Hepatobiliary & Bone diseases glutamyl transferase)
Heart Myocardial infraction
Aspartate liver Liver disease Myocardial infraction
aminotransferase Skeletal Erythrocytes Muscle Disease Liver disease
muscles Slightly in hemolysis Muscle Disease
kidney
Alanine Largest Smaller Congestive heart failure ALT is MORE specific
aminotransferase amount in amounts in ( Cause release from liver ) Hepatocellular disease than AST
liver heart Liver disease In liver Disease
Liver Cholestasis
Gamma-Glutamyl Richest source Hepatobiliary disease Hepatobiliary disease
transferase is kidney Pancreas Alcohol abuse Alcohol abuse
Some times Myocardial infraction
Pancreas conditions
Amylase Pancreas Pancreatitis , ovarian malignancy , ectopic Acute abdominal pain Amylase:creatinine
( Digestive Salivary gland pregnancy, lung carcinoma , cardiac surgery , Pancreatitis x10 clearance ratio
enzyme ) Mump , renal insufficiency , Salpingitis
MacroAmylasemia ( Amylase—IgG)

Lipase Pancreas Pancreatitis Pancreatitis Lipase is more

( Digestive Sensitive than
enzyme ) Amylase

Hind Rifat Sulong HSuloug@hotmail.com

 Cholinestrase two Nervous system
types: Erythrocyte
Lung
Acetylecholinestrase Spleen Organophosphorus
(RBC cholinesterase) Synthsized Low in Hepatic Inhibit Cholinestrase
in Liver Serum disease ( Used to screen for
Heart poisoning )
Serum Cholinestrase Liver
(pseudocholinestrase Pancreas
or acylecholin
acylehydrolase )
Cardiac Muscle Myocardial infarction
Skeletal Brain Muscular dystrophy Isoenzyme
Creatine Kinase muscle Colon intramuscular injection MM ( Muscle
Small intes. Myopathy Muscular disease disease )
Lung &kidney Pregnancy, Surgery , Trauma , Strenuous MB ( Myocardial
Uterus & exercise infraction )
prostate Hypothyroidism
Neoplastic disorders
Lactate Most of tissue Isoenzyme
dehydrogenase contain LDH Myocardial infraction HHHH ( MC , Eryth.)
Low specificity HHHM ( ll )
HHMM & HMMM
(lung and spleen)
MMMM (liver
&skeletal muscle)

Hind Rifat Sulong HSuloug@hotmail.com