What change in enzyme levels suggests a more pure obstructive pathology?

In the context of liver function tests, alkaline phosphatase (ALP) and gamma-glutamyl transferase (GGT) are enzymes that can indicate different types of liver and biliary tract conditions. An increase in ALP levels typically suggests some form of cholestasis or obstructive pathology, especially regarding the bile ducts or liver.

When there is a significant elevation of ALP accompanied by normal GGT levels, this is indicative of a more pure obstructive pathology rather than a disease process that involves the liver parenchyma or cholestasis due to hepatocellular damage. In cases of true obstruction, GGT, which is more closely associated with hepatobiliary disorders, may remain within the reference range if there is no hepatocyte injury or inflammation.

In contrast, if both ALP and GGT are elevated, it could suggest a hepatobiliary disorder rather than a purely obstructive process, as GGT would typically rise in response to liver damage or disease. Therefore, a significant elevation of ALP with normal GGT levels suggests that the increase in ALP is more likely due to an obstructive process rather than other liver-related issues.

Changes in enzyme levels must be interpreted within the context of clinical findings