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Abnormal liver enzymes, or transaminitis, indicate liver inflammation. This review covers common causes, diagnostic methods, and when to consult a hepatologist for elevated liver enzymes.

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Area of Science:

  • Hepatology
  • Clinical Biochemistry

Background:

  • Abnormal liver enzymes are common in clinical practice, stemming from diverse causes.
  • Elevated liver enzymes like ALT, AST, and ALP signify inflammatory liver processes (transaminitis).
  • Abnormal liver function tests, distinct from enzyme elevations, reflect impaired synthetic function (albumin, prothrombin time).

Purpose of the Study:

  • To review common causes of abnormal liver enzymes.
  • To outline diagnostic approaches for elevated liver enzymes.
  • To guide clinical decision-making regarding referral to a hepatologist.

Main Methods:

  • Literature review of common causes and diagnostic modalities for abnormal liver enzymes.
  • Discussion of specific patterns of enzyme elevation.
  • Analysis of clinical scenarios necessitating specialist referral.

Main Results:

  • Common etiologies of abnormal liver enzymes are presented.
  • Diagnostic strategies for evaluating elevated liver enzymes are detailed.
  • Criteria for referring patients with abnormal liver enzymes to a hepatologist are established.

Conclusions:

  • Understanding the distinction between liver enzyme elevation and liver dysfunction is crucial.
  • A systematic approach to diagnosis aids in identifying the cause of abnormal liver enzymes.
  • Timely referral to a hepatologist ensures appropriate management of complex liver conditions.