Table 3.
Comparison of Screening Tests for WD in ALF: 1Ceruloplasmin; 2Alkaline Phosphatase:Total Bilirubin; 3Not applicable; 4Serum Copper. In the chronic liver disease group, zero subjects had an AP:TB ratio < 4, three subjects had Hg <10, one had Cu >200, and the AST:ALT ratio was an ineffective marker of WD.
| Group | Screening Test | Sensitivity % | Specificity % | Likelihood Ratio |
|---|---|---|---|---|
| Acute: | Cp1 (mg/dL)<20 by oxidase |
21 | 84 | 1 |
| Cp (mg/dL) <20 by nephelometry |
56 | 63 | 2 | |
| Hemoglobin (g/dL) <10 | 94 | 74 | 4 | |
| AP:TB2 ratio <4 | 94 | 96 | 23 | |
| AP:TB ratio <4 + AST:ALT ratio >2.2 |
100 | 100 | NA3 | |
| Cu4 (μg/dL) >200 | 75 | 96 | 17 | |
| AST:ALT ratio >2.2 | 94 | 86 | 7 | |
| Chronic: | Cp (mg/dL) <20 by oxidase |
71 | 97 | 21 |
| Cp (mg/dL) <20 by nephelometry |
71 | 79 | 3 |