Elevated Aminotransterase

• Alcohol:

• AST/ALT > 2 PPP 90%,

• > 3 PPP 96%

• Cohen and Kaplan The SGOT/SGPT Ratio: An Indaicator oof Alcoholc Liver Disease Dig Dig Sci 1979: 24

• Alcohol assocaited with mitochondrial injury: AST cytosol, ALT mitochondrial and sensitve to pyrodoxine deficiency

• Elevated Gamma GTP

• Elevated IgA

• Elevated MCV

• Acetomenophen and Alcohol:

• • Acute Alcohol intoxication inhibits Acetomenophen metabolism to NAPQ

• Chronic Induces Cyp 2E1 and decreases Glutathione increasing NAPQ levels and Acetomenophen toxicity