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[Efficient diagnostics for elevated transaminases].

C Folwaczny1

  • 1Arztehaus Harlaching, Isenschmidstr. 19, D-81545 München. FoSterPraxis@aerztehaus-Harlaching.de

MMW Fortschritte Der Medizin
|August 21, 2007
PubMed
Summary
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Diagnosing elevated transaminases involves a stepwise approach. Initial steps include medical history, physical exam, and imaging, followed by specific lab tests for liver conditions and extrahepatic causes like celiac disease.

Area of Science:

  • Hepatology
  • Gastroenterology
  • Internal Medicine

Context:

  • Elevated liver transaminases are common clinical findings requiring systematic diagnosis.
  • Distinguishing between hepatic and extrahepatic causes is crucial for effective patient management.

Purpose:

  • To outline a structured, stepwise diagnostic algorithm for identifying the causes of elevated transaminases.
  • To guide clinicians in prioritizing investigations based on initial findings.

Summary:

  • The diagnostic process begins with a medical history, physical examination, and abdominal sonography.
  • Subsequent steps involve laboratory testing for chronic hepatitis B and C, hereditary hemochromatosis, Wilson's disease, autoimmune hepatitis, and alpha-1-antitrypsin deficiency.
  • Extrahepatic causes are investigated, with celiac disease screening recommended when thyroid-stimulating hormone (TSH) and creatine kinase (CK) levels are inconclusive.

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Impact:

  • Provides a clear diagnostic pathway to improve the efficiency and accuracy of identifying causes of elevated transaminases.
  • Facilitates timely and appropriate treatment by enabling early detection of specific liver and non-liver related conditions.