From: young@clpd.kodak.com (Rich Young)
Subject: Re: Elevated GGTP enzyme a problem?
Originator: young@sasquatch
Reply-To: young@clpd.kodak.com
Organization: Clinical Diagnostics Division, Eastman Kodak Company
Date: Tue, 29 Dec 92 21:53:39 GMT

In article <C00DEw.KrF@techbook.com> szabo@techbook.com (Nick Szabo) writes:
>On a blood chemistry test (cholesterol, bilirubins, alkaline
>phosphate, AST/SGOT, GGTP, etc.) all numbers turned up well
>within normal range except GGTP (67, reference 0-45) and
>triglycerides (196, reference 30-150).  Glucose was slightly
>low but within reference (72, 65-110).
>
>Patient is male, 30, about 80 lbs. overweight, and had an acute 
>relapse of mononucleosis symptoms five years ago after one night of heavy 
>alchohol consumption during recovery from mono.  Currently patient 
>complains of heartburn, anxiety, apathy, frequent thirst & urination,
>episodes of depression.   Should there be any concern here (liver 
>damage, hypoglycemia, diabetes, etc.?)  

   I assume that when you refer to "GGTP," you mean gamma-glutamyltransferase;
   if not, then none of what follows is applicable.

   From FUNDAMENTALS OF CLINICAL CHEMISTRY, 3rd ed., edited by N. W. Teitz,
   Ph.D.; W. B. Saunders Co., 1987.  [All emphasis is in original text.]

	GGT present in serum appears to originate primarily from the hepato-
	biliary system, and GGT activity is elevated in all forms of liver
	disease.  It is highest in cases of INTRA- or POSTHEPATIC BILIARY
	OBSTRUCTION, reaching levels 5-30 times normal.  GGT is more sensitive
	than alkaline phosphatase in detecting obstructive jaundice, 
	cholangitis, and cholecystitis, and its rise occurs earlier and
	persists longer.  Only moderate elevations (2-5 times) are seen in
	INFECTIOUS HEPATITIS, and in this condition GGT determinations are
	less useful diagnostically than are measurements of the transaminases.
	High levels of GGT are also seen in patients with either primary or
	secondary (metastatic) liver cancer; again changes occur earlier
	and are more pronounced than those with other liver enzymes.  Small
	increases (2-5 times normal) of GGT activity are observed in patients
	with FATTY LIVERS, and similar but transient increases are seen in
	cases of drug intoxication.  In acute and chronic PANCREATITIS and
	in some PANCREATIC MALIGNANCIES (especially if associated with
	hepatobiliary obstruction), enzyme activity may be 5-15 times the
	upper limit of normal.  In summary, GGT is the most sensitive
	enzymatic indicator of hepatobiliary disease available at present;
	normal values are rarely found in the presence of liver disease.
	However, GGT is of little value in attempting to discriminate
	between different kinds of liver disease.

	Increased levels of GGT are seen in the sera of heavy drinkers and
	of patients with alcoholic cirrhosis.  In patients receiving anti-
	convulsant DRUGS such as phenytoin and phenobarbital, increased
	levels of the enzyme in serum may reflect induction of new enzyme
	activity and the toxic effects of alcohol and other drugs on micro-
	somal structures in liver cells.  Hepatic complications occurring
	in cystic fibrosis also lead to elevations of GGT.

   PLEASE NOTE: the above is supplied for informational, not diagnostic,
		purposes.


-Rich Young (These are not Kodak's opinions.)
Newsgroups: sci.med