37
Cfinica Chimica Acta, 63 (1975) 37-40 0 Elsevier Scientific Publishing Company,
Amsterdam
- Printed
in The Netherlands
CCA 7185
SERUM XANTHINE
SH. GILER,
OXIDASE
0. SPERLING,
S. BROSH,
IN JAUNDICE
I. URCA and A. DE VRIES
Tel-Aviu U~ive~i~y ~edi&al School, ~epar~rnen~ of Surgery B, The ~e~a~ol~e Unit of the department of Medicine D and the Rogoff- Wellcome Medical Research Institute, Beilinson Medical Center, Petah Tikua (Israel) (Received
March 19, 1975)
Summary Serum xanthine oxidase activity was measured by a radiochemical method in 137 consecutive patients with jaundice of varying etiology and in 40 nonjaundiced patients with liver or other disease. Serum xanthine oxidase was markedly increased, up to 50 times the upper normal limit (mean + 2 S.D.), in 32 out of 34 patients with infectious hepatitis. A slight elevation of serum xanthine oxidase, up to twice the upper normal limit, was found in 2 out of 49 patients with extrahepatic obstructive jaundice and in 4 out of 20 patients with chronic renal failure. In comparison to serum glutamic-oxaloacetic transaminase and lactate dehydrogenase serum xanthine oxidase appeared to be the more sensitive and specific indicator of acute hepatocellular damage.
Introduction The me~urement of the serum levels of certain enzymes, as for instance serum glu~ic-oxaloaceti~ transamin~e (SGOT) and lactate dehydrogenase (LDH), has been applied more or less effectively in the differentiation between medical-nonobstructive and surgical-obstructive jaundice [ 1 J . However, an appreciable overlap exists and pathology involving extrahepatic sources of these enzymes may be diagnostically misleading. Xanthine oxidase is an intracellular enzyme confined in man mainly to the liver [Z] , although a significant activity of this enzyme has been found in jejunal mucosa and in colostrum [3,4]. On the other hand, the liver is the only source of serum xanthine oxidase (SXO) [ 51. Normally, SXO is undetectable or at a very low level. Recently, several studies have demonstrated an increased activity of SXO in acute liver injury [6,7] and immediately following gastric and biliary tract surgery IS] . The present study was undertaken in order to further document the value of the SXO level in the diffe~ntiation between medical and surgical jaundice, as compared to SGOT and LDH.
I
.._
No
(20)
(10)
(4)
O-
group
(
(
(
(
(
(
(
(
(
‘I’
test)
128.9
100)
r
210)
?
960)
+
210)
*
100)
t
in comparison
in parenthesis.
38.04
59.45
271.31
83.81
37.25
56.09
99.17
12.38
158.2
170)
k
310)
k
?
490)
f
~___lllllll.l
(range)
(u/l)
-~--
LDH
? 4524.5
395)
+
is indicated
o-
34.0
o-
63.0
o--
178.50
la-
87.50
o-
26.66
o-
50.0
o-
76.31
O-250)
69.65
o-
133.04
(100-17100)
4469.7
(
81.2
Mean
SXO
activity
AND
?: 1 S.D.
SGOT
Enzyme
TO
(Student’s
in each
(10)
(20)
significance,
of subjects
metastasis
Statistical
failure
hepatitis
infarction
renal
active
* Number
**
.-
Liver
Myocardial
Chronic
jaundice
Chronic
(16)
(12)
(29)
(19)
(23)
jaundice
cirrhosis
Liver
Hemolytic
metastasis
(34)
COMPARED
obstruction
stones
Liver
Bihary
AS
hepatitis
Carcinoma
Extrahepatic
Infectious
.Jaundice
Normal
SXC
11-”
OF
Disease*
LEVELS
TABLE
to
normal
-.
value.
Extrahepatic
>0.2
>0.7
>O.l
>0.9
>O.l
>0.3
>0.8
>0.6
>0.2
Cfinica Chimica Acta, 63 (1975) 37-40 0 Elsevier Scientific Publishing Company,
Amsterdam
- Printed
in The Netherlands
CCA 7185
SERUM XANTHINE
SH. GILER,
OXIDASE
0. SPERLING,
S. BROSH,
IN JAUNDICE
I. URCA and A. DE VRIES
Tel-Aviu U~ive~i~y ~edi&al School, ~epar~rnen~ of Surgery B, The ~e~a~ol~e Unit of the department of Medicine D and the Rogoff- Wellcome Medical Research Institute, Beilinson Medical Center, Petah Tikua (Israel) (Received
March 19, 1975)
Summary Serum xanthine oxidase activity was measured by a radiochemical method in 137 consecutive patients with jaundice of varying etiology and in 40 nonjaundiced patients with liver or other disease. Serum xanthine oxidase was markedly increased, up to 50 times the upper normal limit (mean + 2 S.D.), in 32 out of 34 patients with infectious hepatitis. A slight elevation of serum xanthine oxidase, up to twice the upper normal limit, was found in 2 out of 49 patients with extrahepatic obstructive jaundice and in 4 out of 20 patients with chronic renal failure. In comparison to serum glutamic-oxaloacetic transaminase and lactate dehydrogenase serum xanthine oxidase appeared to be the more sensitive and specific indicator of acute hepatocellular damage.
Introduction The me~urement of the serum levels of certain enzymes, as for instance serum glu~ic-oxaloaceti~ transamin~e (SGOT) and lactate dehydrogenase (LDH), has been applied more or less effectively in the differentiation between medical-nonobstructive and surgical-obstructive jaundice [ 1 J . However, an appreciable overlap exists and pathology involving extrahepatic sources of these enzymes may be diagnostically misleading. Xanthine oxidase is an intracellular enzyme confined in man mainly to the liver [Z] , although a significant activity of this enzyme has been found in jejunal mucosa and in colostrum [3,4]. On the other hand, the liver is the only source of serum xanthine oxidase (SXO) [ 51. Normally, SXO is undetectable or at a very low level. Recently, several studies have demonstrated an increased activity of SXO in acute liver injury [6,7] and immediately following gastric and biliary tract surgery IS] . The present study was undertaken in order to further document the value of the SXO level in the diffe~ntiation between medical and surgical jaundice, as compared to SGOT and LDH.
I
.._
No
(20)
(10)
(4)
O-
group
(
(
(
(
(
(
(
(
(
‘I’
test)
128.9
100)
r
210)
?
960)
+
210)
*
100)
t
in comparison
in parenthesis.
38.04
59.45
271.31
83.81
37.25
56.09
99.17
12.38
158.2
170)
k
310)
k
?
490)
f
~___lllllll.l
(range)
(u/l)
-~--
LDH
? 4524.5
395)
+
is indicated
o-
34.0
o-
63.0
o--
178.50
la-
87.50
o-
26.66
o-
50.0
o-
76.31
O-250)
69.65
o-
133.04
(100-17100)
4469.7
(
81.2
Mean
SXO
activity
AND
?: 1 S.D.
SGOT
Enzyme
TO
(Student’s
in each
(10)
(20)
significance,
of subjects
metastasis
Statistical
failure
hepatitis
infarction
renal
active
* Number
**
.-
Liver
Myocardial
Chronic
jaundice
Chronic
(16)
(12)
(29)
(19)
(23)
jaundice
cirrhosis
Liver
Hemolytic
metastasis
(34)
COMPARED
obstruction
stones
Liver
Bihary
AS
hepatitis
Carcinoma
Extrahepatic
Infectious
.Jaundice
Normal
SXC
11-”
OF
Disease*
LEVELS
TABLE
to
normal
-.
value.
Extrahepatic
>0.2
>0.7
>O.l
>0.9
>O.l
>0.3
>0.8
>0.6
>0.2
