Reference Range. Ionized calcium binds to negatively charged sites on protein molecules, competing with hydrogen ions for the same binding sites on albumin and other calcium-binding proteins. This binding is pH dependent and alters the level of ionized calcium in the blood.An increase in pH, alkalosis, promotes increased protein binding, which decreases free calcium levels.onized calcium is interpreted in conjunction with the total serum calcium measurement. An ionized calcium value within the reference range implies adequate calcium homeostasis, as this is a direct measure of calcium in its active form.
Acute hepatic necrosis. Drug induced liver injury can resemble an acute ischemic or toxic injury to the liver with rapid onset of hepatocellular injury and marked elevations in serum ALT and just as rapid decline once the agent is stopped.rug induced liver injury can resemble acute viral hepatitis with prominence of hepatocellular injury and marked elevations in serum ALT. Symptoms may also be identical those of viral hepatitis, with a prodomal period of fatigue, nausea and poor appetite followed by abdominal discomfort, dark urine and jaundice.
Acute hepatitis can be self-limiting (healing on its own), can progress to chronic hepatitis, or, rarely, can cause acute liver failure. Chronic hepatitis may have no symptoms, or may progress over time to fibrosis (scarring of the liver) and cirrhosis (chronic liver failure).Cirrhosis of the liver increases the risk of developing hepatocellular carcinoma (a form of liver cancer).epatitis may occur with limited or no symptoms, but often leads to jaundice (a yellow discoloration of the skin, mucous membrane, and conjunctiva), poor appetite, and malaise. Hepatitis is acute when it lasts less than six months and chronic when it persists longer.