A comparative study of serum F protein and other liver function tests as an index of hepatocellular damage in epileptic patients

The current state of serum biomarkers of hepatotoxicity

“…Raised ALP activity levels were observed in 13%, 25% and 4% of the CBZ, PHT and VPA groups, respectively. Raised levels of serum F protein in the VPA group and the absence of any associated increases in either GGT or AST activities further supports the suggestion that serum F protein as an indicator of hepatocellular dysfunction associated with anticonvulsant therapy (Callaghan et al, 1994). GGT activity and serum F protein had a correlation coefficient (R value) of 0.56 for CBZ and 0.64 for PHT, both of which were statistically significant.…”

“…GGT activity and serum F protein had a correlation coefficient (R value) of 0.56 for CBZ and 0.64 for PHT, both of which were statistically significant. Evidence indicates that serum F protein is not influenced by enzyme induction (Callaghan et al, 1994).…”

“…The serum F protein concentration was a more sensitive and specific marker of liver damage than conventional liver function tests (AST, ALP, GGT activities) and showed a close correlation with the histological assessment of liver damage (r = 0.86, P < 0.001) . Serum F protein was measured in patients taking anticonvulsant therapies carbamazepine (CBZ) and phenytoin (PHT) as monotherapeutics, in patients receiving multiple drugs, and in patients taking sodium valproate (VPA) (Callaghan et al, 1994). Serum F protein levels were slightly elevated in 6%, 22% and 13% of patients receiving CBZ, PHT and VPA, respectively.…”

Developing a Nomogram for Dose Individualization of Phenytoin in Asian Pediatric Patients Derived From Population Pharmacokinetic Modeling of Saturable Pharmacokinetic Profiles of the Drug

“…26 Increase in ALP may indicate enzyme induction by AEDs rather than hepatic disease, 27,28 whereas the increase in AST is deemed to be indicative of mild hepatotoxicity. Despite the observation that a majority of our patient population, .93% (data not shown) had catalytic activities of AST and ALP that were within the normal range in our population; it seems that when the catalytic activities of these 2 enzymes increase, the clearance of phenytoin in our population also increases.…”

“…Despite the observation that a majority of our patient population, .93% (data not shown) had catalytic activities of AST and ALP that were within the normal range in our population; it seems that when the catalytic activities of these 2 enzymes increase, the clearance of phenytoin in our population also increases. 27,[29][30][31][32] However, severe liver damage in patients on AEDs is rare. 26 Increase in ALP may indicate enzyme induction by AEDs rather than hepatic disease, 27,28 whereas the increase in AST is deemed to be indicative of mild hepatotoxicity.…”