Serum Alcohol Dehydrogenase, an Indicator of Intrahepatic Cholestasis

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Abstract
The activity of alcohol dehydrogenase, an enzyme present principally in liver tissue, was repetitively determined in the serums of 266 patients with hepatic and nonhepatic diseases. The enzyme was present only in patients with liver-cell necrosis. The level of serum activity reflected the extent of parenchymal necrosis, and in acute hepatitis the enzyme was present for as long as three weeks after onset of jaundice. Disappearance from the serum correlated with relief of intrahepatic cholestasis. In patients with hepatocellular necrosis and prolonged cholestasis persistent serum alcohol dehydrogenase activity was present while serum glutamic oxalacetic transaminase values fell close to normal. Only three of 40 patients with jaundice secondary to extrahepatic biliary obstruction had serum alcohol dehydrogenase elevation. These results indicate that serum activity is a specific reflection of hepatocellular necrosis, a good index of intrahepatic cholestasis and of value in the differential diagnosis of intrahepatic cholestasis and extrahepatic biliary obstruction.