- A liver/biliary enzyme that is especially useful
in the diagnosis of obstructive jaundice, intrahepatic cholestasis,
and pancreatitis. GGTP is more responsive to biliary obstruction than
are aspartate aminotransferase (AST) (SGOT) and alanine aminotransferase
- Increased in hepatoma and carcinoma of pancreas.
Useful in diagnosis of metastatic carcinoma in the liver. Increasing
levels in carcinoma patients relate to tumor progression, and diminishing
levels to response to treatment. CEA, alkaline phosphatase, and GGTP
used together are useful markers for hepatic metastasis from breast
and colon primaries. GGTP is elevated in some instances of seminoma.
- Useful in diagnosis of chronic alcoholic liver
disease, but some heavy drinkers do not have GGTP increases. Serial
determinations of serum GGTP, AST, and ALT levels can distinguish recovering
alcoholics who resume drinking from those who remain abstinent. Increase
in body mass is positively correlated with increased GGTP levels. With
MCV of red cells, GGTP is useful as a test for alcoholism.
- GGTP is the test for cholestasis during or immediately
following pregnancy. Commonly elevated in cirrhosis and hepatitis. The
transaminases, AST and ALT rise higher in acute viral hepatitis; these
tests with GGTP and other parameters are best used together in work-up
of liver disease.
- Increased in systemic lupus erythematosus. Very
high levels are common in primary biliary cirrhosis. High GGTP is found
in infants with biliary atresia. It is increased with hyperthyroidism
and decreased in those with hypothyroidism. GGTP is comparable in many
ways to two other biliary tests, LAP and 5' nucleotidase. In some cases,
five tests (including alkaline phosphatase and bilirubin) are necessary
to evaluate the biliary tract. GGTP usually is the most sensitive.
- In ascitic fluid, very high GGTP is said to suggest
hepatoma as opposed to cirrhosis or liver metastases.
- GGTP is helpful to work up elevated alkaline phosphatase
values. GGTP is a biliary excretory enzyme which is more specific for
hepatic disease than is alkaline phosphatase. It is normal in most instances
of renal failure. GGTP has no origin in bone or placenta, unlike alkaline
phosphatase, and age beyond infancy does not influence GGTP levels.
Activity of GGTP is highest in obstructive liver disease. It is commonly
elevated in patients with infectious mononucleosis. When GGTP and alkaline
phosphatase are both high, but one is disproportionately elevated, suspect
the possibility of drug-induced cholestasis (including alcoholism if
it is GGTP which is much higher). GGTP, postprandial glucose, and triglyceride
bear some correlation in certain groups of patients, including alcoholism
and diabetes mellitus. Treatment of hypertriglyceridemia may also lead
to decreased GGTP. GGTP is normal in normal children, adolescents,
and in pregnant women. Unlike AST, it is not elevated in skeletal muscle
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