Evaluation of liver function tests in the paediatric patient
Víctor Fernández Ventureira1, Ignacio Ros Arnal1, Gerardo Rodríguez Martínez2
1Unidad de Gastroenterología y Nutrición Pediátrica, Hospital Universitario Miguel Servet, Zaragoza, Spain.
Anales De Pediatria
|June 6, 2021
Summary
Many children with elevated alanine aminotransferase (ALT) enzyme levels lack proper monitoring, leading to missed opportunities for diagnosing liver disease. Prompt investigation of unexplained hypertransaminasaemia in children is crucial for timely intervention.
Area of Science:
- Pediatric Gastroenterology
- Hepatology
- Clinical Diagnostics
Background:
- Elevated liver function tests, such as alanine aminotransferase (ALT), can indicate underlying disease in asymptomatic patients.
- Non-specific changes in liver tests necessitate careful evaluation to rule out serious conditions.
Purpose of the Study:
- To assess the follow-up and diagnostic yield of unexplained elevated ALT levels in children.
- To determine the proportion of children with abnormal liver tests who are adequately monitored and diagnosed with liver disease.
Main Methods:
- Retrospective cohort study of pediatric patients with elevated ALT.
- Analysis of laboratory records from a central hospital laboratory over a 6-month period.
- Exclusion of patients with pre-existing liver abnormalities or comorbidities.
Main Results:
- Out of 403 patients with elevated ALT, 236 formed the final study sample after exclusions.
- Only 22.6% of patients initially had a diagnosed condition explaining ALT elevation, with suboptimal follow-up (33.3%).
- In the final sample of 236, adequate follow-up was documented in only 29%, leading to a liver disease diagnosis in 13% (9 patients).
Conclusions:
- A significant number of children with unexplained elevated ALT in the studied area receive inadequate monitoring.
- This lack of follow-up results in missed opportunities for early diagnosis and treatment of pediatric liver disease.
- Comprehensive investigation of all children presenting with unexplained hypertransaminasaemia is recommended.
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