Which set represents hepatocellular injury markers?

• A. AST, ALT, LD
• B. ALP
• C. Bilirubin
• D. Ammonia

Answer: (A)

When liver cells are damaged, enzymes inside them spill into the bloodstream. The most informative indicators of hepatocellular injury are the aminotransferases, especially alanine aminotransferase (ALT) which is highly liver-specific, and aspartate aminotransferase (AST) which is present in liver and other tissues like muscle. Lactate dehydrogenase (LD) can also rise with hepatocellular damage, reflecting general cellular breakdown, though it is less specific than the aminotransferases. So a set that includes AST, ALT, and LD aligns with hepatocellular injury.

Alkaline phosphatase tends to rise with cholestasis or biliary tract problems, not primarily with direct liver cell injury. Bilirubin elevation indicates impaired excretion or processing by the liver rather than acute hepatocellular damage itself. Ammonia increases with severe liver dysfunction due to impaired toxin clearance, but it’s more a marker of overall hepatic failure than a direct injury marker of liver cells.