- Evidence of liver or other reticuloendothelial disease as indicated by (any of the following) serum alanine aminotransferase (ALT) > 1.25 times normal, aspartate aminotransferase (AST) > 1.25 times normal, alkaline phosphatase > 1.25 times normal, hepatosplenomegaly, jaundice, or lymphadenopathy on physical examination.