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Abstract

To determine the biochemical profile during the early stages of primary biliary cirrhosis (PBC), the serum concentrations of aspartate aminotransferase, alanine aminotransferase, gamma-glutamyl transpeptidase (GGTP), alkaline phosphatase (ALP), leucine aminopeptidase, total bilirubin and zinc turbidity test were examined retrospectively, 13 months to 19 years (median 9 years) prior to the subsequent histologic diagnosis of PBC in nine patients. Of these, serum GGTP and ALP were elevated before the diagnosis of PBC in most patients, whereas no clear increase in other tests was noted. Moreover, increased concentrations of serum GGTP occurred 1.1–6.6 years earlier than that of serum ALP in three patients and serum GGTP was exclusively elevated in one patient, while only one patient showed the rise in ALP to precede that of GGTP. Serum ALP and GGTP were increased simultaneously or were already high on the first examination in the other three patients. Our results suggest that elevation of serum GGTP may precede that of ALP in the early stages of PBC.