To the Editor.—
In a QUESTIONS AND ANSWERS article (234:99, 1975), Dr Karl appears to confuse the terms "transpeptidase-itis" with "transaminitis." These are far from equivalent terms.While both γ-glutamyl-transpeptidase and the transaminases can suggest parenchymal liver damage when levels are quite elevated, the lesser sensitivity and specificity of serum glutamic oxaloacetic transaminase (SGOT) especially suggest that a modest rise of a transaminase level probably reflects more actual tissue damage somewhere (heart or liver) than does a proportional rise in γ-glutamyl-transpeptidase. The latter enzyme is proving to be an extremely sensitive indicator of subtle liver damage, eg, in heavy drinkers and in patients with occult hepatic neoplasm, when no other laboratory test is abnormal.1-3 However, with increasing use, interpretive difficulties are commencing to surface even with this relatively specific enzyme.4
Loder JS. Sensitivity of Liver Function Tests. JAMA. 1976;235(19):2080. doi:10.1001/jama.1976.03260450012008
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