There is a perception in the clinical community that ALT is specific to liver, but it is also found in skeletal muscle, albeit in lower concentrations than AST.
I have picked up several cases of rhabdomyolysis by adding CK when an isolated raised ALT is found. Undiagnosed diabetes is another cause of a raised ALT which is often overlooked.
Dr. David Oleesky
Consultant Chemical Pathologist & Clinical Lead for Biochemistry
Mid Cheshire Hospitals NHS Foundation Trust
Biochemistry Department, Macclesfield District General Hospital
Victoria Road, MACCLESFIELD, Cheshire, SK10 3BL
Tel: 01625-661826 Fax: 01625-661804
e-mail: [log in to unmask]
________________________________________
From: Clinical biochemistry discussion list [[log in to unmask]] On Behalf Of Soha Zouwail [[log in to unmask]]
Sent: 13 November 2012 14:59
To: [log in to unmask]
Subject: Isolated raised serum ALT
Dear all
May I ask what comments you add to isolated raised serum ALT and which tests to do you suggest- Do you ask for all batteries of tests to exclude different causes? Do you have certain cut-offs for different suggestions? I know that fatty liver is a disease of exclusion but as it is becoming very common, it creates a significant cost to labs. Our gasteroenterologists have suggest to our GPs to add AFP among investigations.
Thank you
Best Wishes
Soha
Soha Zouwail
Consultant Chemical Pathology
University Hospital of Wales
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