Her postcholecystectomy laboratory values markedly improved, with an alanine transaminase
of 131 U/L, aspartate transaminase of 43 U/L, and total bilirubin of 0.6 mg/dL.
In the patient, leucocyte was 6.52 x [10.sup.9]/L, hemoglobin was 147 g/L, hematocrit was 46.6%, thrombocyte was 58 x [10.sup.9]/L, aspartate transaminase was 79.8 U/L, alanine transaminase
was 116.9 U/L, gamma-glutamyl transferase was 156 U/L, alkaline phosphatase was 1114 U/L, total bilirubin was 0.98 mg/dL, direct bilirubin was 0.6 mg/dL and other biochemistry values were all normal.
 Nonstandard abbreviations: SCD, sickle cell disease; RBC, red blood cell; DTI, direct thrombin inhibitor; HIT, heparin-induced thrombocytopenia; PTT, partial thromboplastin time; MSG, monosodium glutamate; AST, aspartate transaminase; SAM, 5-adenosyl methionine; t-PA, tissue plasminogen activator; NAC, N-acetyl-L-cysteine; ALT, alanine transaminase
ALT = alanine transaminase
; AST = aspartate transaminase; BUN = blood urea nitrogen; eGFR = estimated glomerular filtration rate; g = grams; L = liter; and mg = milligrams.
Additionally, recent studies showed that the De Ritis ratio (DRR), which is the ratio of aspartate transaminase (AST) to alanine transaminase
(ALT), is indicative of cellular metabolism and cancer cell turnover .
Because his clinical condition had not improved, he went to the hospital, where he underwent medical tests such as complete blood count (CBC): hemoglobin 13.2 g/dL, hematocrit 39.6%, platelets 343,000/ [mm.sup.3], white blood cells (leucocytes 5200/[mm.sup.3]), liver function Aspartate transaminase (AST) 39.8 U/L, Alanine transaminase
(ALT) 40.1 U/L, gamma-glutamyl transferase (GGT) 346 U/L, and alkaline phosphatase 98.5 U/L.
Item Result White blood cells (/[micro](L) 6,800 Hemoglobin (g/dL) 14.0 Platelets(/[micro](L) 133,000 C-reactive protein (mg/dL) 34.30 Aspartate transaminase (U/L) 79 Alanine transaminase
(U/L) 38 Lactate dehydrogenase (U/L) 393 Creatine Phosphokinase (mg/dL) 307 Fe(/[micro]g/dL) 20 Ferritin(ng/mL) 1924
Her laboratory test results were as follows (Table 1): C-reactive protein level, 6.83mg/dL; aspartate transaminase, 96U/L; alanine transaminase
, 130 U/ L; alkaline phosphatase, 489 U/L; y-glutamyl transpeptidase, 349 U/L; lactate dehydrogenase, 315 U/L; total bilirubin, 1.2 mg/dL; HbA1c, 8.7%; immunoglobulin G, 1574mg/dL; immunoglobulin A, 186 mg/dL; immunoglobulin M, 144 mg/dL.
Liver function tests showed an alkaline phosphatase of 251 U/L, alanine transaminase
of 71U/L, and aspartate transaminase of 92 U/L.
Liver function test revealed a picture of obstructive jaundice with a total bilirubin of 52 umil/L, Alkaline phosphatase 302 [iU] /L, and Alanine transaminase
C-reactive protein (CRP) was 6.71 mg/dL (N [less than or equal to] 3.48), erythrocyte sedimentation rate (ESR) 8mm/h (N: 0-20), parathyroid hormone (PTH) 36.80 pg/ml (N: 12-88), serum creatinine (sCR) 0.81 mg/dL (N: 0.67-1.17), serum urea 46 mg/dL (N: 17-43), aspartate transaminase (AST) 16.9 U/L (N: 0-50), and alanine transaminase
(ALT) 19 U/L (N: 0-50).
Enzyme assay kits for lactate dehydrogenase (LDH) and glucose-6-phosphate-dehydrogenase (G6PDH), acid phosphatase (ACP), alkaline phosphatase (ALP), alanine transaminase
(ALT), aspartate transaminase (AST) kits were products of Randox Laboratories limited; United Kingdom, and were supplied by LIMED International Limited, Idumota Lagos State, Nigeria.
Aspartate transaminase (AST), Alanine transaminase
(ALT) and Lactate dehydrogenase (LDH) were measured by IFCC approved kinetic method.
The results of biochemical analysis were as follows: Hemoglobin: 16.9 gr/dL, hematocrit 49.5%, platelet count: 319/m[m.sup.3], white blood cell count: 11.600/m[m.sup.3], coagulation values: normal, aspartate transaminase: 119 u/L, alanine transaminase
: 41 u/L, lactate dehydrogenase: 378 u/L, gamma glutamyl transferase: 203 u/L, sodium: 136 meq/L, potassium: 7 mmol/L, chlorine: 104 mmol/L, and calcium: 9.33 mg/dL.
The initial laboratory results revealed anaemia (haemoglobin 98 g/L), hepatic injury (aspartate transaminase 968 U/L, alanine transaminase
1520 U/L) and kidney injury (creatinine 147 [micro]mol/L).