Which enzymes are typically elevated in cholestasis?

Which enzymes are typically elevated in cholestasis?

• A. AST and ALT
• B. ALP and GGT
• C. Amylase and lipase
• D. CK and LDH

Answer: (B)

Cholestasis causes a distinctive pattern where enzymes tied to bile flow rise. Alkaline phosphatase comes from the bile ducts, so when bile flow is blocked or impaired, ALP levels go up. Gamma-glutamyl transferase is especially sensitive to biliary problems, and its elevation supports a liver/biliary origin of the ALP rise. Together, a rise in ALP and GGT is the hallmark of cholestasis. In contrast, AST and ALT reflect hepatocellular injury (damage to liver cells), amylase and lipase point to pancreatic involvement, and CK and LDH are more general or reflect muscle or other tissue damage. So the enzyme pattern that best matches cholestasis is elevated alkaline phosphatase and gamma-glutamyl transferase.

Cholestasis causes a distinctive pattern where enzymes tied to bile flow rise. Alkaline phosphatase comes from the bile ducts, so when bile flow is blocked or impaired, ALP levels go up. Gamma-glutamyl transferase is especially sensitive to biliary problems, and its elevation supports a liver/biliary origin of the ALP rise. Together, a rise in ALP and GGT is the hallmark of cholestasis. In contrast, AST and ALT reflect hepatocellular injury (damage to liver cells), amylase and lipase point to pancreatic involvement, and CK and LDH are more general or reflect muscle or other tissue damage. So the enzyme pattern that best matches cholestasis is elevated alkaline phosphatase and gamma-glutamyl transferase.