In which disease is the DeRitis ratio (ALT to AST) usually greater than 1.0?

The DeRitis ratio, which compares the levels of alanine aminotransferase (ALT) to aspartate aminotransferase (AST), is particularly useful in diagnosing and differentiating various liver diseases. In many cases, a DeRitis ratio greater than 1.0 indicates conditions where ALT is more elevated than AST.

In the context of acute hepatitis, the liver is subjected to significant inflammation and damage, leading to a pronounced release of enzymes. In this scenario, ALT, which is more liver-specific than AST, typically rises more than AST, resulting in a DeRitis ratio greater than 1.0. This pattern is especially noted in cases of viral hepatitis.

In contrast, in alcoholic hepatitis, the ratio tends to be less than 1.0 because AST is often elevated more than ALT due to the effect of alcohol on the liver. Chronic hepatitis can also lead to varying ratios depending on the stage of liver disease and underlying pathology. Obstructive jaundice, usually resulting from bile duct obstruction, tends to display different enzyme elevation patterns that do not typically correspond to a DeRitis ratio greater than 1.0.

Thus, recognizing that acute hepatitis is associated with more significant and disproportionate rises in ALT compared to