Liver involvement in Addison's disease

Three patients admitted because of slightly increased serum aminotransferases were found to have Addison's disease. A review of 16 other patients with Addison's disease who had serum aminotransferase activity [aspartate aminotransferase (ASAT) and alanine aminotransferase (ALAT)] determined prior to treatment revealed one more patient with slightly increased aminotransferase activity that could not be explained by known causes of increased serum aminotransferase levels. In all four of these patients, the enzymes normalized within 1 wk of corticosteroid substitution treatment. Liver biopsy in one patient revealed discrete lymphocytic infiltrates in the portal zones. On the basis of these observations, we recommend that the possibility of Addison's disease should be considered in patients with obscure slight hypertransaminasemia.