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Addison's disease and hypertransaminasemia.

George Kalambokis1, Haralampos J Milionis2

  • 1a Lecturer of Internal Medicine, Department of Internal Medicine, School of Medicine, University of Ioannina, 451 10, Ioannina, Greece.

Expert Review of Endocrinology & Metabolism
|February 13, 2019
PubMed
Summary

Elevated liver enzymes (hypertransaminasemia) are rarely linked to endocrine diseases. This study highlights the under-recognized association between Addison

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Area of Science:

  • Endocrinology
  • Hepatology
  • Internal Medicine

Background:

  • Endocrine diseases like diabetes and thyroid dysfunction are seldom linked to elevated serum transaminase activity.
  • The association between Addison's disease and abnormal liver function tests is under-recognized.
  • Addison's disease can be part of autoimmune polyglandular syndrome-1, potentially involving autoimmune hepatitis, or coexist with celiac disease, both linked to hypertransaminasemia.

Purpose of the Study:

  • To review the literature on the prevalence and pathogenesis of hypertransaminasemia in Addison's disease.
  • To highlight the under-recognized association between Addison's disease and elevated liver enzymes.
  • To underscore the diagnostic significance of hypertransaminasemia in identifying adrenal insufficiency.

Main Methods:

Keywords:
Addison’s diseaseaminotransferase levelsautoimmunityhypertransaminasemialiver function test

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  • A thorough literature review was conducted.
  • Studies focusing on Addison's disease and hypertransaminasemia were analyzed.
  • The prevalence and potential mechanisms linking these conditions were examined.

Main Results:

  • Hypertransaminasemia can be a presenting sign of Addison's disease.
  • This association is often overlooked in clinical practice.
  • Identifying this link can lead to timely diagnosis and treatment of adrenal insufficiency, preventing adrenal crisis.

Conclusions:

  • Hypertransaminasemia may serve as a crucial diagnostic clue for Addison's disease.
  • Increased awareness of this association is needed among clinicians.
  • Early detection through liver function tests can facilitate prompt steroid replacement therapy.