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Test ID ALT Alanine Aminotransferase (ALT) (GPT), Serum

Reporting Name

Alanine Aminotransferase (ALT), S

Useful For

Diagnosis and monitoring of liver disease associated with hepatic necrosis

Specimen Type

Serum


Necessary Information


Patient's age and sex are required.



Specimen Required


Container/Tube:

Preferred: Serum gel

Acceptable: Red top

Specimen Volume: 0.5 mL

Collection Instructions:

1. Serum gel tubes should be centrifuged within 2 hours of collection.

2. Red-top tubes should be centrifuged and aliquoted within 2 hours of collection.


Specimen Minimum Volume

0.25 mL

Specimen Stability Information

Specimen Type Temperature Time Special Container
Serum Refrigerated (preferred) 7 days
  Frozen  7 days

Reference Values

Males

≥1 year: 7-55 U/L

Reference values have not been established for patients who are <12 months of age.

Females

≥1 year: 7-45 U/L

Reference values have not been established for patients who are <12 months of age.

Day(s) Performed

Monday through Sunday

Test Classification

This test has been cleared, approved, or is exempt by the US Food and Drug Administration and is used per manufacturer's instructions. Performance characteristics were verified by Mayo Clinic in a manner consistent with CLIA requirements.

CPT Code Information

84460

Clinical Information

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.

Interpretation

Elevated alanine aminotransferase (ALT) values are seen in parenchymal liver diseases characterized by a destruction of hepatocytes. Values are typically at least 10 times above the normal range. Levels may reach values as high as 100 times the upper reference limit, although 20- to 50-fold elevations are most frequently encountered. In infectious hepatitis and other inflammatory conditions affecting the liver, ALT is characteristically as high as or higher than aspartate aminotransferase (AST), and the ALT:AST ratio, which normally and in other condition is less than 1, becomes greater than unity. ALT levels are usually elevated before clinical signs and symptoms of disease appear.

Cautions

Pyridoxal phosphate is a cofactor in the reaction and must be present for optimal enzyme activity.

Clinical Reference

Tietz Textbook of Clinical Chemistry. Edited by CA Burtis, ER Ashwood. Philadelphia, WB Saunders Company, 1994

Method Description

Alanine aminotransferase (ALT) activity is determined by a kinetic method using a coupled enzyme reaction where the rate of NADH consumption is measured at 340 nm. The NADH decrease is directly proportional to the ALT activity.(Package insert: Roche ALT reagent, Indianapolis, IN, January 2000)

Report Available

Same day/1 to 2 days

Reject Due To

Gross hemolysis Reject

NY State Approved

Yes

Method Name

Photometric Rate, L-Alanine with Pyridoxal-5-Phosphate