Serum bile acids and other liver function tests in hepatocellular damage from carbon tetrachloride ingestion

The deliberate ingestion of carbon tetrachloride by a 48-year-old woman provided an opportunity to study the sequential biochemical changes of a severe but self-limited event of hepatocellular damage. The initial phase of cellular injury characterised by high levels of serum aspartate aminotransferase, ferritin and bile acids was followed by a period of partial cholestasis. This was indicated by a marked decrease in secondary bile acids and small rises in alkaline phosphatase and 5' nucleotidase. Improving liver function and regeneration became evident during this period and was associated with abnormal levels of gamma glutamyl transpeptidase. A late rise in serum ferritin and alphafetoprotein may represent a non-specific inflammatory reaction.