TEST OF LIVER INJURY

- Plasma Enzyme Levels

As metabolically complex cells,
hepatocytes contain high levels
of a number of enzymes, with
liver injury, these enzymes may
leak into plasma and can be
useful for diagnosis and
monitoring of live injury

- Cellular Locations of Enzymes

Within the hepatocyte, the
Commonly measured enzymes
are found in specific locations,
the type of liver injury will
determine the pattern of enzymes
changes

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 Cytoplasmic enzymes
- LDH
- AST / ASAT (SGOT)
- ALT / ALAT (SGPT)

 Mitochondrial enzymes
- ASTm (mitochondrial
isoenzyme of AST)

 Canalicular enzymes
- ALP
- GGT

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Mechanisms of enzyme release
 Enzymes are released from hepatocytes by a
variety of mechanisms, these the pattern of
enzyme increase

 The most common patern of injury is

irreversible cell membrane damage
accompanying cell death, leading to
leakage of cytoplasmic and mitochondrial
enzymes

 Acute hepatocellular injury (Hepatitis-

Akut)
- AST activity
- ALT activity

 Ethanol ingestion (mengkonsumsi alkohol)

- ASTm (mitochondrial isoenzyme of
AST)

 Obstructive processes (Cholelithiasis/batu

empedu)
- ALP activity
- GGT activity

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Cholestatic / obstructive
jaundice
Obstruction of drainage
through the biliary tree is the
common cause of acutely
developing jaundice (term :
Cholestatic jaundice)

Since the liver has significant

reserve capacity for handling
bilirubin, jaundice will not
usually develop, unless there
is obstruction of most ducts.

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