Alanine aminotransferase serum

Ribavirin is a guanosine analog synthesized more than 35 years ago, which possesses broad-spectrum antiviral activity against several RNA and DNA viruses in vitro (Sidwell et al. 1972). When administered as monotherapy in patients with chronic hepatitis C, ribavirin induces a decline of serum alanine aminotransferase (ALT) levels while no effect on sustained virologic response is detectable (Di Bisceglie et al. 1992). 

Use of zileuton is uncommon due to the need for dosing four times a day, potential drug interactions, and the potential for hepatotoxicity with the resulting need for frequent monitoring of liver enzymes. In patients started on zileuton, serum alanine aminotransferase concentrations should be monitored before treatment begins, monthly for the first 3 months, every 2 to 3 months for the remainder of the first year, and then periodically thereafter for as long as the patient continues to receive the medication. Zileuton also inhibits the cytochrome P-450 (CYP) mixed function enzyme system and has been shown to decrease the clearance of theophylline, R-warfarin and propranolol.34... 

Tolcapone has been associated with several cases of severe liver failure, including fatalities, and has been removed from the market in some countries. Thus, it should only be used in patients who cannot take or do not respond to entacapone. Serum alanine aminotransferase and aspartate aminotransferase concentrations should be monitored at baseline, then every 2 to 4 weeks for 6 months, and then periodically for the remainder of therapy. Patients who fail to show symptomatic benefit after 3 weeks should discontinue tolcapone. Entacapone has not been associated with liver damage, so monitoring of liver enzymes is not currently recommended.24,25,29... 

Increased serum creatinine and serum alanine aminotransferase in birds, suggestive of kidney and liver alterations (Hoffman etal. 1981)... 

Use of zileuton is limited due to the potential for elevated hepatic enzymes (especially in the first 3 months of therapy), and inhibition of the metabolism of some drugs metabolized by CYP3A4 (e.g., theophylline, warfarin). Serum alanine aminotransferase should be monitored before treatment and then periodically thereafter. 

B. Indications and nse Infergen is indicated for treating chronic hepatitis C virus (HCV) infection in adults with compensated liver disease who have anti-HCV serum antibodies and/or the presence of HCV RNA. It is also effective in the subsequent treatment of patients who did not respond or relapsed after initial interferon therapy. In some patients with chronic HCV infection, Infergen normalizes serum alanine aminotransferase (ALT) concentrations, reduces serum HCV RNA concentrations to undetectable quantities (<100 copies/ml), and improves liver histology. 

E. Therapeutic response Efficacy of Infergen therapy was determined by measurement of serum alanine aminotransferase (ALT) concentrations at the end of therapy (24 weeks) and following 24 weeks of observation after the end of treatment of adults with chronic HCV infection. Serum HCV RNA was also assessed using a quantitative reverse transcriptase polymerase chain reaction (RT-PCR). At the end of 24 weeks of treatment, ALT normalization was observed in 39% of patients on Infergen and in 35% of patients on interferon alfa-2b Intron A). Only 17% of patients in each group... 

Some cases of hepatotoxicity have been reported to be associated with exposure to coumarin. One possible case was reported by Beinssen (1994) and six by Loprinzi et al. (1997). Marshall et al. (1994) reported one case in which elevated serum aminotransferase levels were measured in a patient given 5 g coumarin per day. In two lymphoedema patients given 90 mg coumarin per day for five months, Koch et al. (1997) reported elevated serum alanine aminotransferase activity. Faurschou (1982) reported a case of toxic hepatitis in a patient given coumarin daily for eight weeks, which was characterized by hepatomegaly and elevated serum enzyme levels. All signs of liver toxicity returned to normal on cessation of treatment. 

Oral treatment of adult female Sprague-Dawley rats with 425 mg/kg bw caprolactam 21 and 4 h before killing resulted in a significant increase in serum alanine aminotransferase activity (33%), while hepatic ornithine decarboxylase activity and cytochrome P450 content were not changed significantly (Kitchin Brown, 1989). 

In 183 out of 204 employees in a synthetic leather factory, Wang et o/. (1991) found a significant corrrelation between high exposure concentrations of dimethylformamide (25-60 ppm) and elevated serum alanine aminotransferase and creatine phosphokinase levels. Furthermore, high dimethylformamide exposure concentrations were correlated with symptoms such as dizziness, anorexia, nausea and epigastric pain. 

Pattern of serum alanine aminotransferase (ALT) and bilirubin in the plasma, following poisoning with the toxic mushroom Amanita phalloides. 

Curcumin and turmeric protect the liver against several toxicants both in vitro and in vivo. Reddy and Lokesh (1992) found that oral administration of curcumin (30mg/kg body weight) for 10 days lowered the liver and serum lipid peroxide levels, serum alanine aminotransferase (ALAT), aspartate aminotransferase (ASAT) and lactate dehydrogenase (LDH), enhanced by i.p. injection of iron in rats. 

HBV infection is diagnosed by the presence of anti-HBc antibodies, absence of anti-HBsAg antibodies and the presence of ffBsAg in serum. HBeAg is indicative of active disease. Liver biopsy will show the presence of HBV DNA and liver damage, as indicated by elevated levels of serum alanine aminotransferases (ALTs). 

Figure 223. Effect of DHA on hepatic triglyceride levels and serum alanine aminotransferase (ALT) levels in diet-induced lipodystrophy model mice.

Tarao, K., Rino, Y., Ohkawa, S., Tamai, S., Miyakawa, K., Takakura, H., Endo, O., Yoshitsugu, M., Watanabe, N., Matsuzaki, S. Close association between high serum alanine aminotransferase levels and multicentric hepatocarcinogenesis in patients with hepatitis C virus-associated cirrhosis. Cancer 2002 94 1787-1795... 

Walter, B., Co, R. and Makowski, E. (1983). A solid phase reagent strip for the colorimetric determination of serum alanine aminotransferase on the Seralyzer. Clin. Chem. 29, 1168-1169, Abstr. 64. 

S234 Keen, J.W.M. (1989). Performance of a reflectometric technique for serum alanine aminotransferase determinations. J. Automat. Chem. 11, 134-136. 

Hepatotoxicity is the limiting side effect in tacrine therapy. About 50% of those patients given tacrine show elevated serum alanine aminotransferase (ALT) levels indicating some degree of hepatotoxicity. In almost all cases, these changes are noted within the first 12 weeks of treatment. Jaundice is a rare finding. 

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