Dear All,
The classical teaching is that GGT is from the liver but on a U/gram
basis there is far more in the kidney and of course there is
considerable in the brain for glutathione synthesis. Concerning the
former many renal transplant patients have undergone upper GI ultasound
for nought when in fact they were having a mild rejection episode.
JML
Dr John M. Land MBA PhD FRCPath FRCP
Clinical Director Biochemical Medicine
UCLH NHS Foundation Trust
Neurometabolic Unit Box 105
National Hospital
Queen Square
London WC1N 3BG
44-(0)20-7829-8768
Dr John M. Land
Clinical Director Biochemical Medicine
UCLH NHS Foundation Trust
Neurometabolic Unit Box 105
National Hospital
Queen Square
London WC1N 3BG
44-(0)20-7829-8768
-----Original Message-----
From: Clinical biochemistry discussion list
[mailto:[log in to unmask]] On Behalf Of Nick Miller
Sent: 13 October 2008 10:54
To: [log in to unmask]
Subject: Re: Isolated increased GGT in a young lady ...
Michael,
Gamma-glutamyl transferase in the serum is of hepatic microsomal origin
and increase in its activity in the blood is usually explained by
induction of synthesis or by alteration of cellular structure (i.e.
increased permeability of the hepatocyte membrane).
The situation you report is suggestive of increased cell permeability
and leakage of the enzyme from the hepatocyte, which can be genetic
(I've seen it in families) or can result from a previous toxic insult.
I would suggest serum bile acids and glutathione-S-transferase activity
as further tests (apart from the obvious ones).
It is probably not a cause for concern if you don't find anything else
wrong.
Regards,
Nick Miller
London
2008/10/10 Dr. Michael Steiner <[log in to unmask]>:
> Dear colleagues,
>
> A GP asks about the differential diagnosis of increased GGT in a 20
> year old young lady. She is perfectly fine except for slightly
> elevated GGT (appr 2.5 upper limit) which has been persisting for a
> couple of months. Transaminases, bilirubin, alkaline phosphatase, and
> LDH are normal. No evidence of drugs, alcohol, and current therapy of
> any kind including hormonal contraception.
>
> One suggestion was early-stage primary biliary cirrhosis (or similar).
> Any comments on that one?
>
> What I am confused most about is that the increase concerns ONLY and
> EXCEPTIONALLY GGT. Any idea if a macro-GGT has ever been described? If
> so, any advice how rule in/out a macro-GGT?
>
> Your suggestions will be much appreciated.
>
> Best regards,
>
> Mike
>
> Dr Michael Steiner
> Medizinisches Labor Rostock
> Suedring 81
> D-18059 Rostock
> GERMANY
>
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