ALT (Alanine Aminotransferase, SGPT)

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ALT

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ALT is an enzyme found mostly in the liver; smaller amounts are also found in the kidneys, heart, and muscles. When the liver is damaged, ALT is released into the bloodstream, hence increasing the concentration that can be detected in a blood test. This often happens before more obvious symptoms of liver damage occur, such as jaundice (yellowing of the eyes and skin).

About

Alanine aminotransferase (ALT) is present primarily in liver cells. In viral hepatitis and other forms of liver disease associated with hepatic necrosis, serum ALT is elevated even before the clinical signs and symptoms of the disease appear. Although serum levels of both aspartate aminotransferase (AST) and ALT become elevated whenever disease processes affect liver cell integrity, ALT is a more liver-specific enzyme. Serum elevations of ALT are rarely observed in conditions other than parenchymal liver disease. Moreover, the elevation of ALT activity persists longer than does AST activity.

Preparation

No test preparation is needed, although you should inform your doctor about any drugs you are taking.

Indications

An ALT test is usually requested with other laboratory investigations to evaluate a patient who has symptoms of a liver disorder. ALT is used to identify liver damage. Some of these symptoms include jaundice, dark urine, nausea, vomiting, abdominal swelling, unusual weight gain, and abdominal pain. ALT can also be used, either by itself or with other tests, for patients at risk of developing a liver disease such as:
  • persons who have a history of known or possible exposure to hepatitis viruses,
  • those who drink too much alcohol,
  • those whose family have a history of liver disease,
  • people who take drugs that might damage the liver
  • those who are overweight or who have diabetes
In people with mild symptoms, such as tiredness or loss of energy, ALT may be tested to make sure they do not have chronic (long-term) liver disease. ALT is often used to monitor the treatment of persons who have liver disease, to see if the treatment is working, and maybe requested either by itself or along with other blood tests.

Interpretation

Very high concentrations of ALT (more than 10 times the highest normal level) are usually due to acute (short-term) hepatitis, often due to a viral infection. In acute hepatitis, the concentration of ALT usually stays high for about 1–2 months but can take as long as 3–6 months to return to normal.


ALT concentrations are usually not as high in chronic hepatitis, often less than 4 times the highest normal level: in this case, ALT levels often vary between normal and slightly increased, so doctors may request the test frequently to see if there is a pattern. A moderately high ALT can also occur occasionally when there is high alcohol intake, diabetes or raised serum triglycerides, all of which can cause fatty liver.


In some liver diseases, especially when the bile ducts are blocked (cholestasis), when a person has cirrhosis, or when liver cancer is present, the concentration of ALT may be close to normal.

Disclaimer

The laboratory test results are NOT to be interpreted as results of a "stand-alone" test. The test results have to be interpreted after correlating with suitable clinical findings and additional supplemental tests/information. Your healthcare providers will explain the meaning of your tests results, based on the overall clinical scenario. Certain medications that you may be currently taking may influence the outcome of the test. Hence, it is important to inform your healthcare provider of the complete list of medications (including any herbal supplements) you are currently taking. This will help the healthcare provider interpret your test results more accurately and avoid unnecessary chances of a misdiagnosis.

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