Alcoholic hepatitis laboratory findings

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Assosciate Editor(s)-In-Chief: Prashanth Saddala M.B.B.S

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Laboratory Findings

  • AST:ALT (aspartate aminotransferase:alanine aminotransferase) classically 2:1. The ratio of aspartate aminotransferase to alanine aminotransferase is usually > 2.[1]
    • Reason for ratio not clear
      • There may be disproportional damage to mitochondria releasing AST
      • Alcoholics may have relative deficiencies of pyridoxal-6-phosphatase
    • > 300-500 worry about other hepatotoxins
  • Alkaline phosphatase, gamma-glutamyltranspeptidase (GGT) and bilirubin often rise proportionally, and may persist for weeks after transaminases normalize.
  • A leucocytosis is commonly seen. If other causes can be excluded, the degree of rise correlates with severity of hepatic injury.

References

  1. Sorbi D, Boynton J, Lindor KD (1999). "The ratio of aspartate aminotransferase to alanine aminotransferase: potential value in differentiating nonalcoholic steatohepatitis from alcoholic liver disease". Am. J. Gastroenterol. 94 (4): 1018–22. PMID 10201476.

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