Serum liver enzymes

Urgert, R., Schulz, A. G. M., Katan, M. B., Effects of cafestol and kahweol from coffee grounds on serum lipids and serum liver enzymes in humans, Am J Clin Nutr, 61, 149, 1995... 

Herbal remedies that have been reported to be he-patotoxic include chaparral (Larrea tridentata), germander (Teucrium chamaedrys), and life root (Senecio aureus) [18]. Cases reported patients developing jaundice, fatigue, pruritus, markedly elevated serum liver enzyme levels, severe cholestasis, hepatitis, and hepatocellular injury or necrosis documented by serial liver biopsies [19-21]. Signs and symptoms may occur as early as 3 weeks to as late as 7 months following ingestion [20,21]. 

Some cellular necrosis was observed in the liver of male rats receiving a 5% p-CD diet and in female rats receiving a 2.5 and 5.0% p-CD diet. An increase in portal inflammatory cell infiltration was also observed in male rats receiving the 2.5% p-CD diet and male and female rats receiving the 5.0%o p-CD diet. These observations were considered to represent a mild hepa-totoxicity (mechanism unknown), which was further evidenced by increases in serum liver enzymes. 

Acute reversible ciclosporin toxicity occurred in a renal transplant patient a few days after colchicine was administered for an acute attack of gout (SEDA-16, 115). Other potential adverse effects of combining colchicine with ciclosporin include diarrhea, increases in serum liver enzymes, bilirubin, and creatinine, and less often severe myalgia (SEDA-19, 101). Acute myopathy, associated with neuropathy in one case, has been observed in two young renal transplant recipients (SEDA-22, 119). 

The onset of the pneumonia was preceded by raised serum liver enzymes and hjrpertension. The acute respiratory failure improved with prednisolone and colestyramine. 

Nodular regenerative hyperplasia of the liver has been reported in three patients with inflammatory bowel disease who had taken tioguanine for more than a year and who had raised serum liver enzymes all three had histological foci of nodular regenerative hyperplasia, which was best seen with reticulin silver impregnation (4). 

In the early clinical trials a range of doses of zafirlukast were used. With higher doses (80 mg bd) serum liver enzymes were occasionally raised. In subsequent clinical trials with 20 mg bd, a raised alanine transaminase activity was twice as common as in patients taking placebo (1). 

Monitor serum liver enzyme levels and report if liver enzyme levels elevate. 

Hepatic Effects. Icterus, jaundice, abdominal pain, liver failure, acute toxic hepatitis, and elevated serum liver enzymes were among the effects reported in four individuals who repeatedly ingested chaparral capsules (160-1,500 mg chaparral/day) over a period ranging from 6 weeks to 10 months. 

Serum liver enzymes, blood urea nitrogen, creatinine levels, glucose levels, electrolytes, bilirubin levels, iron levels, ferritin levels, lipid levels, and complete blood count of four patients prescribed an extract of creosote bush in 90% ethanol were within the normal range and were unchanged by exposure to the extract of creosote bush (Heron and Yamell 2001). The authors also reported that an additional eight patients who had been prescribed an extract of creosote bush had no noticeable adverse effects, but no information as to blood chemistry was available for these patients. 

Serum phenobarbital levels can be increased by valproate, which may result in excessive sedation and lethargy. Small reductions in valproate levels have also been reported. Combined use of phenobarbital and valproate may cause an increase in serum liver enzymes. 

Haidukewych D, John G. Chronic valproic acid and coantiepileptic drug therapy and incidence of increases in serum liver enzymes. Ther Drug Monit ( 9S6) 8, 407-410. 

Biotransformation Serum liver enzyme levels Blood levels of bile acids or specific drugs and their metabolites, serum liver enzyme levels, isotope excretion scans... 

Protein Growth velocity, serum liver enzyme levels, liver size by examination Urine and serum amino acid levels, serum glucose serum proteins (e.g., albumin, prealbumin, clotting factors, alpha-l-antitrypsin, transferrin), serum liver enzyme levels, liver size by examination and ultrasound... 

Lipid Liver size by examination, serum liver enzyme levels Serum lipid levels (cholesterol, phospholipids, triglycerides), serum glucose, liver size, and fat content by examination and ultrasound, urine organic acids... 

Serum liver enzymes (e.g., alanine aminotransferase (ALT), alkaline phosphatase (AP)] and bilirubin levels are elevated. 

Studies Serum CK was high 3200 lU/L (upper normal for women was 240 lU/L). Serum aspartate aminotransferase (AST), alanine aminotransferase (ALT), and lactate dehydrogenase (LDH) were also rather highly elevated. But, the serum liver-enzyme y-glutamyl transpeptidase (GGTP which can leak... 

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