GPT and acute respiratory distress syndrome: Severe rhabdomyolysis is associated with an elevation in both AST and ALT; however, coagulation markers and bilirubin levels can be used to differentiate ALI from rhabdomyolysis.8 In our patient, an elevated international normalized ratio (INR), total bilirubin, ALT, and AST with only a mild elevation in CK on initial presentation provided evidence of true ALI.