According to the Tokyo 2018 guidelines, the diagnosis of acute cholangitis is established through clinical, laboratory, and imaging methods (fever and/or chills, elevated CRP levels, leukocytosis or other elevated inflammatory parameters, jaundice, and a 1.5-fold increase in aspartate transaminase (AST), alanine transaminase (ALT), alkaline phosphatase (ALP), gamma-glutamyl transpeptidase (GGT) levels, with biliary dilation detected on imaging).169. The gene discussed is GPT; the disease is acute cholangitis.