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[What to do when faced with a chronic elevation of transaminases]
A Delamarre1, G Boillet2, V de Lédinghen1
1Service d'hépatologie et de transplantation hépatique, hôpital Haut-Lévêque, centre hospitalier universitaire de Bordeaux, Bordeaux, France; BRIC, Inserm U1312, université de Bordeaux, Bordeaux, France.
La Revue De Medecine Interne
|August 19, 2023
Summary
Elevated liver enzymes (transaminases) are common in primary care. This guide covers causes like alcohol and fatty liver disease, assessment, and when to refer patients to specialists.
Area of Science:
- Hepatology
- Internal Medicine
- Primary Care Diagnostics
Context:
- Chronic elevation of transaminases presents a frequent challenge in primary care settings.
- Understanding the epidemiology and pathophysiology is crucial for effective management.
- Normal transaminase values and common etiologies form the basis of initial assessment.
Purpose:
- To provide a practical overview of chronic transaminase elevation for primary care physicians.
- To outline the initial diagnostic steps and differential diagnoses.
- To clarify the general practitioner's role and referral criteria for specialist consultation.
Summary:
- The article reviews the epidemiology, pathophysiology, and normal values of transaminases.
- It details common causes such as alcohol, fatty liver disease, and viral hepatitis, alongside first-line assessments.
- Less frequent, extra-hepatic causes, and additional diagnostic tests are also discussed.
Impact:
- Empowers general practitioners to confidently manage elevated transaminases in primary care.
- Facilitates timely and appropriate referral of patients requiring specialist care.
- Improves patient outcomes by ensuring efficient diagnostic pathways for liver enzyme abnormalities.
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