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.
1 Hepatocellular jaundice-a type of jaundice that occurs as a result of liver disease or injury. 2  Hemolytic jaundice-a type of jaundice that occurs as a result of hemolysis (an accelerated breakdown of erythrocytes-red blood cells) leading to an increase in production of bilirubin.ymptoms of jaundice include: 1  Yellow tinge to the skin and the whites of the eyes. 2  Pruritis (itchiness). 3  Fatigue. 4  Abdominal pain-typically indicates a blockage of the bile duct. 5  Weight loss.