The activity of the primarily lysosomal hydrolase, beta-hexosaminidase (EC 3.2.1.30), was studied in serum from 53 patients with bleeding esophageal varices, portal hypertension, and liver cirrhosis (31 alcoholic, 13 cryptogenic, and 9 primary biliary). The serum enzyme activity was determined on 89 occasions and was increased in 93%. There was no difference in the distribution between the three patient groups, but in patients who underwent portal-systemic shunt surgery there was a significant increase after 9-12 months. Serum beta-hexosaminidase activity correlated significantly with other biochemical tests known to be influenced by portal-systemic shunting. It is concluded that determination of this enzyme might become a useful liver test, since it sensitively detects liver disease and also might be specific, since besides liver disease only pregnancy and lysosomal disorders are known to show considerable elevations in serum activity.
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