Disease effects Serum activity of the leakage enzymes increases when a sufficient number of hepatocytes experience increased membrane permeability. Serum levels depend on both the number of cells affected and the severity of injury to individual cells. Serum levels do not correlate with reversibility. Increases are not specific with regard to the nature of the injury. Viral, bacterial, fungal, immune-mediated, idiopathic.
Inflammation can be suppurative or non-suppurative.
Note that primary bile duct obstruction may result in secondary hepatocellular injury as accumulated bile acids are toxic to cells. Leakage enzyme levels in end-stage liver disease or portosystemic shunts may be normal or only mildly increased due to reduced number of cells and minimal active injury. Drugs, chemicals, plants. These can cause very high enzyme activity if associated with diffuse necrosis. Variable increases are possible depending on the extent of active hepatocellular injury.