GPT and blood coagulation disease: For hepatic toxicity, these grades do not reflect clinical severity; for example, 20-fold elevation of either alanine aminotransferase (ALT), aspartate aminotransferase (AST), or alkaline phosphatase (ALP) alone is classified as life-threatening (grade 4) hepatitis without evidence of any hepatic functional impairment such jaundice, coagulopathy, ascites, or encephalopathy.