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The liver transaminases aspartate transaminase (AST or SGOT) and alanine transaminase (ALT or SGPT) are useful biomarkers of liver injury in a patient with some degree of intact liver function. [2] [3] [4] Most liver diseases cause only mild symptoms initially, but these diseases must be detected early. Hepatic (liver) involvement in some ...
Alanine transaminase (ALT), also known as alanine aminotransferase (ALT or ALAT), formerly serum glutamate-pyruvate transaminase (GPT) or serum glutamic-pyruvic transaminase (SGPT), is a transaminase enzyme (EC 2.6.1.2) that was first characterized in the mid-1950s by Arthur Karmen and colleagues. [1]
The magnitude of AST and ALT elevations vary depending on the cause of the increase, such as intensity of recent muscular exertion or type of hepatocellular injury. The following refer to the " upper reference limit " (URL), also known as the "upper limit of normal" (ULN), which depend on the source and are typically 40-50 U/L (0.67-0.83 μkal ...
The proportion of AST to ALT in hepatocytes is about 2.5:1, but because AST is removed from serum by the liver sinusoidal cells twice as quickly (serum half-life t 1/2 = 18 hr) compared to ALT (t 1/2 = 36 hr), so the resulting serum levels of AST and ALT are about equal in healthy individuals, resulting in a normal AST/ALT ratio around 1.
Gilbert syndrome is a phenotypic effect, mostly associated with increased blood bilirubin levels, but also sometimes characterized by mild jaundice due to increased unconjugated bilirubin, that arises from several different genotypic variants of the gene for the enzyme responsible for changing bilirubin to the conjugated form.
Increased reticulocytes and the presence of schistocytes in the blood smear of the patient observed during CBC indicates hemolysis. [28] If the patient has hemolytic jaundice, serum testing will show that conjugated bilirubin will only account for less than 15% of the total serum bilirubin due to the increase of unconjugated bilirubin. [33]
It is the most common cause of metabolic acidosis in hospitalized patients. The most serious form occurs during various states of shock, due to episodes of decreased liver perfusion. Kidney failure results in decreased acid excretion and increased bicarbonate excretion. Toxins that result in acidic metabolites may trigger lactic acidosis.
Excessive alcohol consumption is a significant cause of hepatitis and is the most common cause of cirrhosis in the U.S. [33] Alcoholic hepatitis is within the spectrum of alcoholic liver disease. This ranges in order of severity and reversibility from alcoholic steatosis (least severe, most reversible), alcoholic hepatitis , cirrhosis, and ...