2023-05-17 15:46:48
An elevation of the aminotransferase level above the laboratory reference value indicates cytolysis. It has been shown that chronic (> 3 months) elevation of transaminases is associated with an increased risk of mortality.
The two enzymes, alanine aminotransferase (ALT) and aspartate aminotransferase (AST), are released into the bloodstream when the hepatocyte membrane is damaged, but there is a poor correlation between the extent of liver damage and the level of transaminases. ALT is mainly present in the liver and is a more specific marker of hepatocellular damage. ASTs are enzymes present in the liver, but also in cardiac and skeletal muscle cells, kidney, brain, pancreas, lungs, leukocytes and erythrocytes.
Thus, in the face of an isolated increase in AST, a muscular origin must be eliminated.linked to a muscle pathology or physical effort, by measuring creatine phosphokinase (CPK) serum; exceptionally, it is the sign of haemolysis or the formation of macro-AST (complexes between AST and immunoglobulins identifiable by electrophoresis of isoenzymes).
Attention : an increase in transaminases linked not to cytolysis but to cholestasis is defined by an increase in alkaline phosphatase most often associated with an increase in GGT (in this case, abdominal ultrasound is indicated in 1re intention to specify the cause).
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