Your source for clinical lab test information.

Sample

Precautions

  1. Avoid hemolysis, because RBC contains increased ALT and AST.
  2. Drugs that may increase the SGPT value are like acetaminophen, aminosalicylic acid, ampicillin, allopurinol, cephalosporin, chlorpropamide, clofibrate, cloxacillin, codeine, indomethacin, INH, Methyldopa, methotrexate, nalidixic acid, quinidine, phenylbutazone, phenytoin, salicylates, tetracycline, and propanol. 
  3. Ideally perform the test as soon as possible or on the same day. Because the storage of the sample is not satisfactory.

Indication

  1. Diagnose liver diseases.
  2. Monitor the liver diseases after the treatment.
  3. It differentiates jaundice from liver disease or hemolytic anemia.

Pathophysiology

  1. There is a high concentration of SGPT in the liver.
  2. This enzyme is present in cytosolic and mitochondrial forms in the liver.

  1. SGPT enzyme is specific for the liver cell necrosis.
    1. First cytosolic SGPT is released and in the case of necrosis, then mitochondria SGPT is released into circulation. 

  1. ALT catalyzes the reaction and it is reversible.

SGPT catalyze the reaction.

  

  1. The small amount found in kidney, heart, and muscles.
    1. There is always a low level of this enzyme in the blood.
    2. This is also normally found in bile, CSF, and saliva.
    3. It is not found in the urine unless there is kidney lesion.
  2. SGPT activity persists longer than the SGOT.
  3. This enzyme is raised before there are clinical findings of jaundice.
  4. In viral hepatitis, the SGPT / SGOT ratio is greater than 1.
  5. Other than viral cause the SGPT / SGOT ratio is less than 1.
  6. SGPT 1.5 to 8 times more than the normal level seen in:
    1. Early, late and subclinical hepatitis.
    2. Chronic hepatitis.
    3. Alcoholic hepatitis.
    4. Chemical hepatitis.
    5. passive congestion with centrilobular necrosis.
    6. Rye’s syndrome.
    7. Cholangitis.
    8. Hemochromatosis.
  7. SGPT >8 to 10 times than the normally seen in:
    1. Mostly in acute hepatitis.
  8. SGPT >30 times than the normally seen in :
    1. Drugs toxicity like acetaminophen in alcoholics.
  9. SGPT level as compared to serum (1) in the heart is 450 times, the liver is 2850 times, the kidney is 1200 times, skeletal muscle is 300 times, the pancreas is 130, the spleen is 80 times, the lung is 45 times, RBCs 7 times. 
  10. AST/ALT ratio is usually greater than 1 in:
    1. The patient with alcoholic cirrhosis.
    2. Liver congestion.
    3. Metastatic tumor of the liver.
    4. The ratio of less than 1 is seen in:
    5. Acute hepatitis.
    6. Viral hepatitis.
    7. Infectious mononucleosis.
      1. The ratio will be less accurate if the AST level is more than 10 times the normal.

NORMAL

Source 1

Age Male U/L Female U/L
Newborn 12 months 13 to 45 13 to 45
one to 60 years 10 to 40 7 to 35
60 to 90 years 13 to 40 10 to 28
>90 years 6 to 38  5 to 24

Source 2

Another source

The increased SGPT level is seen in:

  1. Viral hepatitis. There is markedly increased the level.
  2. Drug-induced hepatitis.
  3. Chronic hepatitis.
  4. Infectious mononucleosis.
  5. Intrahepatic cholestasis.
  6. Cholecystitis.
  7. Active cirrhosis.
  8. Metastatic tumors of the liver.
  9. Obstructive jaundice.
  10. Alcoholic cirrhosis.
  11. The mild increase is seen in :
    1. Myosotis.
    2. Pancreatitis.
    3. Myocardial infarction.
    4. Shock.
    5. Infectious mononucleosis.

Acute Viral hepatitis SGPT Pattern:

  1. This rises before the appearance of jaundice.
  2. Peak level after 7 to 12 days of jaundice.
  3. Normal level after 3 to 4 weeks of onset of jaundice.

Table showing the increase of SGPT in various conditions:
Clinical condition
The rise in SGPT level with reference to the normal value
Viral hepatitis and liver diseases  may reach 100 times
Infectious hepatitis  ALT > AST
Toxic hepatitis Extremely high level
Infectious mononucleosis 20 times
Intrahepatic cholestasis may be raised 
Extrahepatic cholestasis Very high level
Cirrhosis 4 to 5 times or higher
Metastatic carcinoma 5 to 10 times
 Acute myocardial infarction within normal limits or very mild increase
Progressive muscular dystrophy May reach 8 times
Dermatomyositis May reach 8 times

Possible References Used

Back to tests