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[Elevated aminotransferse levels--diagnostic approach]
Jasmina Simonović-Babić1, Dragan Delić, Neda Svirtlih
1Institut za infektivne i tropske bolesti, Klinicki centar Srbije, Beograd.
Medicinski Pregled
|January 29, 2005
Summary
Elevated alanine aminotransferase (ALT) levels may not always indicate liver disease. A liver biopsy is recommended for persistently high ALT to rule out serious conditions and provide reassurance.
Area of Science:
- Hepatology
- Clinical Biochemistry
- Diagnostic Medicine
Context:
- Elevated aminotransferase levels, particularly alanine aminotransferase (ALT), are common indicators of liver cell injury.
- However, raised ALT levels of unknown origin present a diagnostic challenge in clinical practice.
- Serum ALT activity is frequently used to assess hepatic disease but may not always confirm liver injury.
Purpose:
- To investigate the common causes of elevated aminotransferase levels in patients presenting with unexplained ALT elevations.
- To evaluate the diagnostic utility of liver biopsy in cases of persistently elevated ALT.
Summary:
- A study of 27 patients with elevated ALT revealed diverse underlying conditions, including nonalcoholic steatohepatitis (NASH), chronic hepatitis of unknown etiology, and autoimmune hepatitis.
- A significant number of patients (six) showed normal results or no specific changes, highlighting that elevated ALT does not always signify liver disease.
- Liver biopsy is suggested for persistently elevated ALT (more than twice the normal value) to exclude serious pathology.
Impact:
- This study underscores the importance of a comprehensive diagnostic approach beyond just ALT levels for liver health assessment.
- Findings can help clinicians better interpret elevated ALT results and decide on further investigations.
- Recommending biopsy for persistent elevations provides a pathway to reassure patients and physicians about the absence of severe liver disease.