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Related Experiment Video

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Approach to Elevated Liver Enzymes.

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  • 1Department of Gastroenterology, MedStar Georgetown University Hospital, 3800 Reservoir Road Northwest, Washington, DC 20007, USA.

Primary Care
|July 29, 2023
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Summary

Abnormal liver tests are common in primary care. This article reviews the causes, diagnosis, and management of elevated liver enzymes, guiding practitioners on evaluation based on clinical presentation.

Keywords:
Alcohol-associated liver diseaseDILIDrug-induced liver injuryHepatitisLiver function testsNAFLDNon-alcoholic fatty liverTransaminitis

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Area of Science:

  • Hepatology
  • Primary Care Medicine
  • Clinical Diagnostics

Background:

  • Abnormal liver tests present a frequent challenge in primary care settings.
  • Tests are ordered for various reasons, including abdominal symptoms, alcohol use, and medication side effects.
  • Evaluation requires careful consideration of clinical presentation and liver injury patterns.

Purpose of the Study:

  • To provide a comprehensive overview of elevated liver enzymes.
  • To focus on the epidemiology, pathophysiology, clinical presentation, diagnostic work-up, and management.
  • To emphasize the most common etiologies of abnormal liver testing.

Main Methods:

  • Review of epidemiological data on abnormal liver tests.
  • Analysis of pathophysiological mechanisms underlying liver enzyme elevation.
  • Discussion of clinical presentation and diagnostic strategies.
  • Outline of management approaches for common causes.

Main Results:

  • Elevated liver enzymes are a common diagnostic challenge.
  • Clinical presentation and injury pattern guide the diagnostic work-up.
  • Numerous factors contribute to abnormal liver tests, including alcohol use and medication effects.
  • A systematic approach is essential for accurate diagnosis and management.

Conclusions:

  • Effective management of abnormal liver tests relies on understanding their epidemiology and pathophysiology.
  • Primary care practitioners can effectively evaluate and manage most cases of elevated liver enzymes.
  • A guided diagnostic approach ensures appropriate patient care and timely intervention.