Liver Enzymes

1.Hepatocellular damage 2. Choleostatsis

11)Alkaline phosphatase,
2) 5'-nucleotidase,
AST ALT 3) γ-Glutamyl transpeptidase
(γ-
GGT).

Type of Location of the E Normal Abnorma Interpretation

enzyme Value l values
AST Inside every 0-40 300 IU/L Nonspecific damage , can’t
hepatocytes IU/L X7 distinguish as a hepatocellular
(Other than liver - damage or Cholestasis…..
…..)
ALT Inside hepatocytes 0-45 300 IU/L ‘same
X7
ALT: AST ALT > / = hepatocellular injury
AST
AST> ALT 2:1 Suggestive
3:1 Suggestive of alcoholic liver disease,
Alcoholic liver disease >300 U/L and
the
ALT is often normal.
ALT is low during this alcoholic liver
disease …………..
ALT , AST >1000 extensive hepatocellular injury
U/L (1) viral hepatitis,
(2)ischemic liver injury (prolonged
X 25 hypotension or acute heart failure),
(folds) or
 (3) toxin- or drug-induced liver
injury.
Not obstructive jaundice
change

ALP- in or near the bile Non-pathological conditions- (mild-

(Alkaline canalicular moderate)
phosphatas membrane Age > 60
e of hepatocytes. Blood group-
) Development Phases-
distinct Pregnancy-
isoenzymes found
in the Pathological elevations
liver, bone, 1. X3< elevation; can’t
placenta, and, less distinguish either
commonly, small hepatocellular or cholestasis
intestine 2. X4 > cholestatic liver
disorders, infiltrative liver
diseases such as cancer and
amyloidosis.

in or near the bile

2) 5'- canalicular
nucleotidas membrane
e, and of hepatocytes
(Light -Brown)
γ-Glutamyl endoplasmic
transpeptid reticulum and in
ase (GGT) bile duct epithelial
— cells.(Green cells )

Differential Diagnosis,

Level jaundice/ ALP AST ALT Interpretation

Bile
Absent X3 early cholestasis
+ Moderate - - Intrahepatic
cholestasis;

drug-induced
hepatitis, primary
biliary cirrhosis,
 rejection of
transplanted liver,
and, rarely,
alcohol-induced
steatonecrosis

Siginificantly very - - Extrahepatic

+++++ high cholestasis/post
hepatic jaundice

-in obstructive
jaundice

cancer, common
duct stone,
sclerosing
cholangitis, or bile
duct stricture

Identification and separation – Gel electr…….

ALP is one of the Cancer Biomarker- 1. Regan and Nagao…………