What laboratory finding is most indicative of acute liver failure?

Elevated serum aminotransferases, specifically aspartate aminotransferase (AST) and alanine aminotransferase (ALT), are significant markers of liver cell injury. When the liver undergoes acute failure, the integrity of hepatocytes is compromised, leading to the release of these enzymes into the bloodstream. Typically, ALT is more liver-specific than AST, making elevated levels of these enzymes particularly reflective of acute liver damage.

In cases of acute liver failure, a marked rise in AST and ALT is often observed and serves as a critical indicator of the extent of liver injury. It's not just the elevation of these enzymes themselves that is of importance, but also their levels can correlate with the degree of hepatic dysfunction and can help guide clinical management.

Other laboratory findings, such as decreased white blood cell count or normal serum lipase levels, do not specifically indicate liver failure. Increased serum creatinine levels might suggest renal impairment, which can occur in severe cases of liver failure, but they do not directly reflect liver function or injury. Thus, elevated serum aminotransferases provide a clear and direct assessment of liver health and are the most indicative of acute liver failure.