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The Significance of Alterations in Serum Enzymes in the Differential Diagnosis of Jaundice

AMA Arch Intern Med. 1957;100(4):635-641. doi:10.1001/archinte.1957.00260100119014.
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Introduction  The differential diagnosis in a patient presenting with jaundice rests primarily on a comprehensive historical review and a complete physical examination. Accordingly, in most instances, the type and cause of jaundice can be defined with resort to tests of urine, stool, and blood primarily to confirm the clinical impression. Occasionally the clinical setting makes the etiological explanation of jaundice obscure, and in these situations blood tests of liver function may contribute fundamentally to the diagnosis. The battery of liver function tests include measurements of a multiplicity of parameters of liver physiology, normal and pathologic. The contribution of each test may at times be crucial, but as a rule one test tends to confirm another and/or the clinical conclusion. With the increasing number of tests available to study liver disease clinically, a point of diminishing returns is reached if routine reliance is placed on a large battery of blood tests


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