Skip to main content
NCBI home page
Journal of Clinical Pathology logoLink to Journal of Clinical Pathology
. 1982 Jun;35(6):638–641. doi: 10.1136/jcp.35.6.638

Serum gamma-glutamyltransferase and alkaline phosphatase in rheumatoid arthritis.

R J Spooner, D H Smith, D Bedford, P R Beck
PMCID: PMC497740  PMID: 6123527

Abstract

Serum gamma-glutamyltransferase (GGT) and alkaline phosphatase (AP) were assayed in 98 consecutive patients with rheumatoid arthritis. Twenty-three patients had increased GGT activities and 45 an increased AP activity. Twelve patients showed an increase in both enzyme activities and AP isoenzyme studies were performed on seven of this group. In three subjects an increase in the bone isoenzyme was observed and in three others the increase in activity was attributed to the liver isoenzyme. The remaining patient, who probably suffered from coexistent primary biliary cirrhosis, showed an increase in both bone and liver isoenzymes. The liver involvement, suggested by the alkaline phosphatase isoenzyme results, was largely confirmed by the butanol extraction of GGT. The changes in these enzymes in this small series could not be related definitely to drug therapy. It is concluded that though increases in GGT and AP are common in rheumatoid arthritis, this does not necessarily indicate hepatic involvement. Further isoenzyme studies are needed to define the extent to which organs other than the liver bring about increases in these serum enzymes in rheumatoid disease.

Full text

PDF
638

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. 1958 REVISION of diagnostic criteria for rheumatoid arthritis. Arthritis Rheum. 1959 Feb;2(1):16–20. doi: 10.1002/1529-0131(195902)2:1<16::aid-art1780020104>3.0.co;2-9. [DOI] [PubMed] [Google Scholar]
  2. Agostoni A., Ideo G., Stabilini R. Serum gamma-glutamyl transpeptidase activity in myocardial infarction. Br Heart J. 1965 Sep;27(5):688–690. doi: 10.1136/hrt.27.5.688. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. Beck P. R. Butanol extraction of serum and urinary gamma-glutamyltransferase and its application in clinical diagnosis. Ann Clin Biochem. 1978 May;15(3):151–156. doi: 10.1177/000456327801500131. [DOI] [PubMed] [Google Scholar]
  4. Bryant C. E. Salicylate-induced hepatotoxicity: a review. J Okla State Med Assoc. 1978 Jul;71(7):284–287. [PubMed] [Google Scholar]
  5. Cockel R., Kendall M. J., Becker J. F., Hawkins C. F. Serum biochemical values in rheumatoid disease. Ann Rheum Dis. 1971 Mar;30(2):166–170. doi: 10.1136/ard.30.2.166. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. Fenech F. F., Bannister W. H., Grech J. L. Hepatitis with biliverdinaemia in association with indomethacin therapy. Br Med J. 1967 Jul 15;3(5558):155–156. doi: 10.1136/bmj.3.5558.155. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Gardner M. D., Scott R. Frequency distribution and 'reference values' of plasma alkaline phosphatase (EC 3.1.3.1) activity in the adult population of a Scottish new town. J Clin Pathol. 1978 Dec;31(12):1202–1206. doi: 10.1136/jcp.31.12.1202. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. Goldberg D. M., Martin J. V. Role of gamma-glutamyl transpeptidase activity in the diagnosis of hepatobiliary disease. Digestion. 1975;12(4-6):232–246. doi: 10.1159/000197682. [DOI] [PubMed] [Google Scholar]
  9. Kataja J., Gordin R. Serum gamma-glutamyl transpeptidase and alkaline phosphatase in severely injured patients. Acta Chir Scand. 1970;136(4):277–281. [PubMed] [Google Scholar]
  10. Lowe J. R., Pickup M. E., Dixon J. S., Leatham P. A., Rhind V. M., Wright V., Downie W. W. Gamma glutamyl transpeptidase levels in arthritis: a correlation with clinical and laboratory indices of disease activity. Ann Rheum Dis. 1978 Oct;37(5):428–431. doi: 10.1136/ard.37.5.428. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Moss D. W., Whitby L. G. A simplified heat-inactivation method for investigating alkaline phosphatase isoenzymes in serum. Clin Chim Acta. 1975 May 15;61(1):63–71. doi: 10.1016/0009-8981(75)90398-8. [DOI] [PubMed] [Google Scholar]
  12. Rau R. Die Gamma-Glutamyltranspeptidase bei der chronischen Polyarthritis. II. Einfluss von Medikamenten. Z Rheumatol. 1977 Jan-Feb;36(1-2):49–59. [PubMed] [Google Scholar]
  13. Ritchie D. M., Boyle J. A., McInnes J. M., Jasani M. K., Dalakos T. G., Grieveson P., Buchanan W. W. Clinical studies with an articular index for the assessment of joint tenderness in patients with rheumatoid arthritis. Q J Med. 1968 Jul;37(147):393–406. [PubMed] [Google Scholar]
  14. Schenker S., Olson K. N., Dunn D., Breen K. J., Combes B. Intrahepatic cholestasis due to therapy of rheumatoid arthritis. Gastroenterology. 1973 Apr;64(4):622–629. [PubMed] [Google Scholar]
  15. Sherlock S., Scheuer P. J. The presentation and diagnosis of 100 patients with primary biliary cirrhosis. N Engl J Med. 1973 Sep 27;289(13):674–678. doi: 10.1056/NEJM197309272891306. [DOI] [PubMed] [Google Scholar]
  16. Webb J., Whaley K., MacSween R. N., Nuki G., Dick W. C., Buchanan W. W. Liver disease in rheumatoid arthritis and Sjøgren's syndrome. Prospective study using biochemical and serological markers of hepatic dysfunction. Ann Rheum Dis. 1975 Feb;34(1):70–81. doi: 10.1136/ard.34.1.70. [DOI] [PMC free article] [PubMed] [Google Scholar]

Articles from Journal of Clinical Pathology are provided here courtesy of BMJ Publishing Group

RESOURCES