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Extreme serum elevations of aspartate aminotransferase
R D Johnson1, M L O'Connor, R M Kerr
1Department of Pathology, Bowman Gray School of Medicine of Wake Forest University, Winston-Salem, North Carolina, USA.
The American Journal of Gastroenterology
|August 1, 1995
Summary
Extreme elevations in serum aspartate aminotransferase (AST) are often caused by hypoxic hepatitis. This condition, along with other causes, is associated with high mortality rates in hospitalized patients.
Area of Science:
- Clinical Biochemistry
- Hepatology
- Critical Care Medicine
Background:
- Serum aspartate aminotransferase (AST) is a key biomarker in clinical biochemistry.
- Extreme elevations in AST (>$3000$ U/L) are rare but clinically significant events.
Purpose of the Study:
- To investigate the incidence, causes, and mortality associated with extreme serum AST elevations.
- To identify the primary etiologies behind these significant biochemical abnormalities.
Main Methods:
- Retrospective review of medical records from a tertiary-care hospital over one year.
- Analysis of patients with serum AST levels exceeding $3000$ U/L.
Main Results:
- An incidence rate of approximately 2 per 1000 admissions for AST >$3000$ U/L was observed.
- Hypoxic hepatitis was the leading cause (29/56 cases), followed by toxic and viral hepatitis.
- Overall mortality for these patients was high, at 55% (31/56).
Conclusions:
- Hypoxic hepatitis is the most frequent cause of extreme AST elevations.
- Mortality was significantly higher in patients with AST elevation due to hypoxic hepatitis (75%) compared to other causes (33%).