Re: Diagnosed with PSC seven years ago--numbers then and now--help me understand?

[Guest guest]

By the way, I thought I should note that I do not have any symptoms,

nor have I ever to my knowledge. I certainly have those of you who

have been dealing with the symptoms in my thoughts.

Best,

[Guest guest]

Hi ,

Perhaps this article:

Guidelines for Performance of Laboratory Tests of Liver Function and

Injury

http://www.nacb.org/lmpg/hepatic/2_hepatic_Guidelines.pdf

will help explain some of your lab results.

The section on GGT (p. 11) may be particularly helpful in answering

your questions:

" GGT is slightly more sensitive than ALP in obstructive liver

disease. GGT is increased an average of 12 times the upper reference

limit in 93-100% of those with cholestasis, while ALP is increased an

average of 3 times the upper reference limit in 91% of the same

group. (52, 53, 54) GGT appears to increase in cholestasis by the

same mechanisms as does ALP. (54, 55) GGT is increased in 80-95% of

patients with any form of acute hepatitis. (55, 56) Other factors

that affect GGT activity are summarized in Table 5. Patients with

diabetes, hyperthyroidism, rheumatoid arthritis and obstructive

pulmonary disease often have an increased GGT; the reasons for these

findings are largely obscure. After acute myocardial infarction, GGT

may remain abnormal for weeks. (62) These other factors cause a low

predictive value of GGT (32%) for liver disease. (63) "

So GGT can potentially go up much higher than ALP during cholestasis.

But, as the article says there could be other reasons for elevated

GGT, including diabetes or rheumatoid arthritis, or alcohol

consumption .... " Because of lack of specificity, GGT should be

reserved for specific indications such as determining the source of

an increased alkaline phosphatase " .

The best measures of liver function over the long term are actually

albumin and prothrombin time, discussed on pages 15- 18.

Best regards,

Dave

(father of (22), PSC 07/03; UC 08/03)

[Guest guest]

,

That article fills in a whole lot of gaps for me. Thanks so much. I

just did not know what to compare my numbers to. This article is

very helpful in that regard.

Best to you and yours,

>

> Hi ,

>

> Perhaps this article:

>

> Guidelines for Performance of Laboratory Tests of Liver Function

and

> Injury

>

> http://www.nacb.org/lmpg/hepatic/2_hepatic_Guidelines.pdf

>

> will help explain some of your lab results.

>

> The section on GGT (p. 11) may be particularly helpful in answering

> your questions:

>

> " GGT is slightly more sensitive than ALP in obstructive liver

> disease. GGT is increased an average of 12 times the upper

reference

> limit in 93-100% of those with cholestasis, while ALP is increased

an

> average of 3 times the upper reference limit in 91% of the same

> group. (52, 53, 54) GGT appears to increase in cholestasis by the

> same mechanisms as does ALP. (54, 55) GGT is increased in 80-95% of

> patients with any form of acute hepatitis. (55, 56) Other factors

> that affect GGT activity are summarized in Table 5. Patients with

> diabetes, hyperthyroidism, rheumatoid arthritis and obstructive

> pulmonary disease often have an increased GGT; the reasons for

these

> findings are largely obscure. After acute myocardial infarction,

GGT

> may remain abnormal for weeks. (62) These other factors cause a low

> predictive value of GGT (32%) for liver disease. (63) "

>

> So GGT can potentially go up much higher than ALP during

cholestasis.

> But, as the article says there could be other reasons for elevated

> GGT, including diabetes or rheumatoid arthritis, or alcohol

> consumption .... " Because of lack of specificity, GGT should be

> reserved for specific indications such as determining the source of

> an increased alkaline phosphatase " .

>

> The best measures of liver function over the long term are actually

> albumin and prothrombin time, discussed on pages 15- 18.

>

> Best regards,

>

> Dave

> (father of (22), PSC 07/03; UC 08/03)

>