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Related Experiment Videos

Liver enzyme alteration: a guide for clinicians.

Edoardo G Giannini1, Roberto Testa, Vincenzo Savarino

  • 1Gastroenterology Unit, Department of Internal Medicine, University of Genoa, Genoa, Italy. egiannini@unige.it

CMAJ : Canadian Medical Association Journal = Journal De L'Association Medicale Canadienne
|February 3, 2005
PubMed
Summary

Interpreting abnormal liver enzyme levels in healthy patients is challenging. This review guides clinicians through hepatocellular and cholestatic patterns, common causes, and initial investigations for liver damage markers.

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Area of Science:

  • Hepatology
  • Clinical Biochemistry
  • Internal Medicine

Background:

  • Isolated alterations in liver biochemical markers can be diagnostically challenging in asymptomatic individuals.
  • Understanding liver functional anatomy and the pathophysiology of enzyme changes is crucial for accurate interpretation.
  • A systematic approach is needed to differentiate causes of abnormal liver function tests.

Purpose of the Study:

  • To provide a clinical guide for interpreting isolated alterations in liver enzyme levels.
  • To review the functional anatomy and pathophysiology of liver enzyme alterations.
  • To classify enzyme alterations and outline common causes and initial investigations.

Main Methods:

  • A schematic approach classifying enzyme alterations into predominantly hepatocellular or cholestatic patterns.

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  • Review of abnormal enzymatic activity within these subgroups.
  • Discussion of common etiologies and recommended initial diagnostic workup.

    • Main Results:

    • Enzyme alterations can be categorized based on whether they are predominantly hepatocellular or cholestatic.
    • Common causes for each pattern of liver enzyme elevation are identified.
    • Initial investigations are suggested to differentiate between potential causes.

    Conclusions:

    • A structured approach aids in diagnosing the cause of abnormal liver enzymes in seemingly healthy individuals.
    • Distinguishing between hepatocellular and cholestatic patterns is key to guiding further investigation.
    • Timely and appropriate initial investigations can lead to accurate diagnosis and management.