Which factor is primarily elevated in autoimmune hepatitis compared to alkaline phosphatase?

In autoimmune hepatitis, the primary elevation observed is in the levels of aminotransferases, specifically aspartate aminotransferase (AST) and alanine aminotransferase (ALT). These enzymes are commonly released into the bloodstream when there is hepatic inflammation or damage, which is characteristic of autoimmune hepatitis.

The elevation of AST and ALT is significant because it reflects the degree of liver cell injury and is often much higher than the alkaline phosphatase levels, which are more commonly associated with cholestatic liver diseases. In autoimmune hepatitis, while alkaline phosphatase can be elevated, it does not reach the same high levels as AST and ALT, thus being less indicative of the disease state.

Additionally, the bilirubin levels can also be elevated in autoimmune hepatitis but are not as consistently high as AST/ALT levels. Although lactate dehydrogenase (LDH) may be elevated in various conditions, it is not a specific marker for autoimmune hepatitis.

Therefore, the correct answer highlights the significant increase in AST/ALT, which serves as a critical diagnostic criterion for assessing liver inflammation in autoimmune hepatitis.