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.

  • 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.