Gamma glutamyl transpeptidase (GGTP), glutamic oxaloacetic transaminase (GOT), and glutamic pyruvic transaminase (GPT) were measured serially in the serum and cerebrospinal fluid (CSF) of 22 patients with fresh stroke and an equal number of age- and sex-matched healthy control subjects.
It was observed that levels of these enzymes in the CSF of control subjects were very low but were significantly elevated (p < 0.001) in both serum and CSF in patients with stroke. The elevation was greater in the CSF than in the serum and was maximum during the first four days of stroke. Thereafter, the enzymatic activity declined. Of all these enzymes, GGTP in CSF correlated best with the clinical picture. It was possible to differentiate between the ischemic and hemorrhagic type of stroke on the basis of CSF levels of GGTP ( > 60.0 units in hemorrhagic stroke). There was no correlation between GGTP levels in CSF and serum or among GOT, GPT, and GGTP in CSF.
It can be concluded, therefore, that estimation of GGTP in CSF is helpful not only in predicting the degree of cerebral damage and functional outcome of the patient following stroke but also in differentiating the type of stroke.
Get full access to this article
View all access options for this article.
References
1.
Wolintze AH, Lawrence DJ, Christoff N., et al: Serum and cerebrospinal fluid enzymes in cerebrovascular diseases . Arch Neurol20:54-61, 1969.
2.
Acheson J., James EC, Hutchinson EC, Weshhed R.: Serum creatinine kinase levels in cerebral vascular disease. Lancet1:1306-1307, 1965.
Wakim KG, Fleisher GA: Effect of experimental cerebral infarction on transaminase activity in serum cerebrospinal fluid and infarcted tissue. Proc Staff Meet Mayo Clin31:391-399, 1956.
5.
Green JB, Oldewurtel HA, O'Doherty DS, Forester FM: Cerebrospinal fluid transaminase and lactic dehydrogenase activities in neurological disease. Arch Neurol Psych80:148-156, 1958.
6.
Zinchenko VA , Batunir LS, Somova TV, Sytinskii IA: Gamma glutamyl transpeptidase activity of cerebrospinal fluid of stroke patients. Lab Delo6:51-52, 1983.
7.
Akimov GA, Zinchenko VA, Sytinsky IA, Palaguta VD: The gamma glutamyl transferase activity in haemorrhagic and ischemic stroke . Sov Med1:3-5, 1985.
8.
World Health Organization, technical reports. Cerebrovascular disease. Prevention, treatment, and rehabilitation . 469:6-25, 1971.
9.
Reitman S., Frankel S.: A colorimeteric method for determination of serum glutamic oxaloacetic transaminase and serum glutamic pyruvic transaminase. Am J Clin Path28(1):56-63, 1957.
10.
Goldbarg JA , Pineda EP, Smith EE, et al: A method for the colorimetric determination of gamma glutamyl transpeptidase in human serum. Enzyme activity in health and disease. Gastroenterology44:127-133, 1963.
11.
Mellick RS, Bessett RL: The cerebrospinal fluid glutamic oxaloacetic transaminase activity in neurological diseases. Lancet1:904-906, 1964.
Kohli RK, Srivastva MP, Bahl AN, Sikand PC: GOT activity in cases of cerebrovascular accidents with special reference to its prognostic significance. J Assoc Phys Ind26:485-489, 1978.
15.
Mistry CJ, Singhavi VS, Kezi MY: The cerebrospinal fluid GOT and GPT in various neurological disorders . J Assoc Phys Ind19:311-314, 1971.
16.
Fleischer GA , Wakim KG, Goldstein NP: Glutamic oxaloacetic transaminase and lactic dehydrogenase in serum and cerebrospinal fluid of patients with neurological disorders. Proc Staff Meet Mayo Clin32:188-197, 1957.
17.
Lieberman J. , Daiber O., Dulkin ST, et al: Glutamic oxaloacetic transaminase in serum and cerebrospinal fluid of patients with cerebrovascular accidents . N Engl J Med257:1201-1207, 1957 .
