[Distribution pattern of isoenzymes of alkaline phosphatase in patients with various forms of hepatitis (author's transl)].

The isoenzymes of alkaline phosphatase were measured on admission to hospital, and then weekly over a 2 to 3 month period, in 40 patients presenting with uncomplicated acute hepatitis, 12 patients with cholestatic hepatitis, and 10 patients with histologically confirmed chronic persistent hepatitis. In acute uncomplicated hepatitis the increase in total alkaline phosphatase is not due to a cholestatic reaction of the damaged liver, but reflects the impaired catabolic capacity of the liver cells to degrade alkaline phosphatases from intestine and bone, as well as that of hepato-biliary origin. The isoenzyme distribution pattern is the same as found in normal healthy subjects. The increase in total alkaline phosphatase in patients with cholestatic hepatitis results from this impaired catabolic capacity for degradation of all isoenzymes, together with an increase in cholestatic reflux of hepato-biliary enzymes. In patients with chronic persistent hepatitis the raised total alkaline phosphatase activity at each point during the illness is due to this catabolic impairment of degradation of all isoenzymes. A cholestasis is not seen. The isoenzyme distribution pattern remains normal; only the enzyme activity due to the intestinal fraction, when compared with the acute hepatitis, is slightly, but significantly, raised.