A 45-year-old alcoholic has GGT 320 U/L (normal <55), ALP 130 U/L (normal <120), and normal bilirubin. The BEST interpretation is:
- A Obstructive jaundice with cholestasis
- B Isolated GGT elevation indicating microsomal enzyme induction by alcohol ✓
- C Acute viral hepatitis
- D Haemolytic jaundice with liver involvement
Correct answer: B. Isolated GGT elevation indicating microsomal enzyme induction by alcohol
Explanation
GGT is highly sensitive to alcohol consumption because ethanol strongly induces hepatic microsomal enzymes (CYP2E1 system), leading to disproportionate GGT elevation relative to ALP. The near-normal ALP and bilirubin exclude significant cholestasis. GGT elevation out of proportion to ALP is the biochemical hallmark of alcohol-induced hepatic microsomal induction.
Reference: Harper's Illustrated Biochemistry, 32nd ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
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