Applications of Serum Enzymology

Throughout the text, serum aldolase has been determined by the spec-trophotometric method (BIO, L7, S29) and both transaminases by the colorimetric method (R2). The normal ranges (R13) in conventional units are for serum aldolase 2.3-8.8 units per ml (mean 5.7 units), for SCOT 12-36 units per ml (mean 19 units), and for SGPT 4-24 units per ml (mean 12 units). In each figure the activity of serum aldolase is denoted by an uninterrupted line, of SCOT by long strokes, and of SGPT by short strokes (Figs. 7-15). 

Patients with increasing muscular weakness may offer widely diverse histories, signs and symptoms of their complaint. On examination, the condition may often be related at once to disease of the central or peripheral nervous system or, if clearly defined, to one of the classical myopathies. Doubts may frequently arise, however, and where further 

Condition Age (years) Sex Serum aldolase SCOT SGPT 

Serum enzyme activities are normal (A3, A5, C9, G13, D17, E5, G2, H7, Kl, M18, Ol, 02, P4, R14, SI, S13, S14, S16, S17, S22, S26, T8, W12) in patients with neurogenic muscular weakness (Table 1), but are raised, sometimes grossly, in those with primary disease of muscle. Such elevations in a patient with obscure muscle weakness and without other evident disease are very strong indications of the presence of myopathy. 

Similar serum enzyme elevations are found in polymyositis (A3, B4a, B20, D2, D17, E5, H7, KIO, M15, M18, Pl, P4, P5, P7, R15, S15, S26, T8, W12, W19), a nonspecific inflammatory myopathy sometimes associated with neoplastic disease but in general related to the collagen diseases and likewise responsive to corticosteroid therapy. The condition occurs at all ages in both sexes, may be acute or insidious with perhaps a normal erythrocyte sedimentation rate, may or may not be painful, or may be accompanied by an erythematous rash (dermatomyositis). Characteristically the earliest appearance of weakness is in the muscles of the pelvic 

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