A COMPARATIVE-STUDY OF SERUM-F-PROTEIN AND OTHER LIVER-FUNCTION TESTSAS AN INDEX OF HEPATOCELLULAR DAMAGE IN EPILEPTIC PATIENTS

Gamma glutamyl transferase (GGT) and alkaline phosphatase (ALP) may no t be sensitive indicators of hepatocellular damage in patients taking anticonvulsant drugs as raised levels may only reflect enzyme inductio n. Aspartate aminotransferase (AST) is a specific, but relatively inse nsitive marker of liver damage and has a poor correlation with liver h istology. Serum F protein is found in high concentration in the liver and levels are not influenced by enzyme induction. We measured serum F protein levels in patients taking carbamazepine (CBZ) and phenytoin ( PHT) as monotherapy and in patients receiving multiple drugs. We compa red the results with patients taking sodium valproate (VPA). Serum F p rotein levels were elevated in 6%, 22% and 13% of patients receiving C BZ, PHT and VPA, respectively. Raised GGT levels were reported for bot h the CBZ (26%) and PHT (78%) groups. Raised ALP levels were observed in 16%, 25% and 4% of the CBZ, PHT and VPA groups, respectively. Raise d levels of serum F protein in the VPA -roup and the absence of any as sociated increases in either GGT or AST may further support the sugges tion that serum F protein is an indicator of hepatocellular dysfunctio n associated with anticonvulsant therapy. However, further correlation with liver histology is required.