No elevation of serum gamma-glutamyl transpeptidase level in a polymyositis case with intrahepatic cholestasis

A 57-year-old male with polymyositis developed jaundice which was induced by intrahepatic cholestasis. During his course before and after discontinuation of the administration of an anabolic steroid hormone which was suspected as the possible agent, serum gamma-glutamyl transpeptidase (gamma-GTP) levels were consistently within normal level, although serum levels of bilirubin, A1-P and LAP were elevated. Difference in the levels among biliary tract enzymes was discussed with regard to the mechanism of elevation of serum biliary tract enzyme levels, and a possible significance of the examination of bile juice was suggested.