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Liver involvement in Addison's disease.

R G Olsson1, A Lindgren, L Zettergren

  • 1Department of Medicine II, Sahlgrenska Hospital, University of Gothenburg, Sweden.

The American Journal of Gastroenterology
|April 1, 1990
PubMed
Summary
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Addison's disease can cause slightly elevated liver enzymes, known as hypertransaminasemia. Early diagnosis and corticosteroid treatment can normalize these enzyme levels.

Area of Science:

  • Endocrinology
  • Hepatology
  • Internal Medicine

Background:

  • Serum aminotransferase elevations (aspartate aminotransferase and alanine aminotransferase) are common clinical findings.
  • The differential diagnosis for mild, unexplained hypertransaminasemia can be broad.
  • Addison's disease, an adrenal insufficiency disorder, is not typically associated with liver enzyme abnormalities.

Observation:

  • Three patients presenting with mild hypertransaminasemia were diagnosed with Addison's disease.
  • A retrospective review identified an additional Addison's disease patient with unexplained elevated aminotransferases.
  • In all four cases, liver enzymes normalized within one week of initiating corticosteroid replacement therapy.

Findings:

  • Addison's disease may present with mild, unexplained elevations in serum aminotransferases.

Related Experiment Videos

  • Liver biopsy in one patient showed portal zone lymphocytic infiltrates, suggesting an autoimmune process.
  • The normalization of aminotransferases upon corticosteroid treatment supports a direct link to adrenal insufficiency.

    • Implications:

    • Consider Addison's disease in the differential diagnosis of patients with obscure mild hypertransaminasemia.
    • This finding may prompt earlier diagnosis of Addison's disease in patients with unexplained liver enzyme elevations.
    • Further research could explore the underlying mechanisms connecting adrenal insufficiency and transient liver enzyme changes.