Skip to main page content
Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
, 71 (6), 1105-10

Mildly Elevated Liver Transaminase Levels in the Asymptomatic Patient

Affiliations
  • PMID: 15791889
Review

Mildly Elevated Liver Transaminase Levels in the Asymptomatic Patient

Paul T Giboney. Am Fam Physician.

Erratum in

  • Am Fam Physician. 2005 Jul 1;72(1):41

Abstract

Mild elevations in liver chemistry tests such as alanine transaminase and aspartate transaminase can reveal serious underlying conditions or have transient and benign etiologies. Potential causes of liver transaminase elevations include viral hepatitis, alcohol use, medication use, steatosis or steatohepatitis, and cirrhosis. The history should be thorough, with special attention given to the use of medications, vitamins, herbs, drugs, and alcohol; family history; and any history of blood-product transfusions. Other common health conditions, such as diabetes, heart disease, and thyroid disease, can cause or augment liver transaminase elevations. The recent American Gastroenterological Association guideline regarding the evaluation and management of abnormal liver chemistry tests proposes a practical, algorithmic approach when the history and physical examination do not reveal the cause. In addition to liver chemistries, an initial serologic evaluation includes a prothrombin time; albumin; complete blood count with platelets; hepatitis A, B, and C serologies; and iron studies. Depending on the etiology, management strategies may include cessation of alcohol use, attention to medications, control of diabetes, and modification of lifestyle factors such as obesity. If elevations persist after an appropriate period of observation, further testing may include ultrasonography and other serum studies. In some cases, biopsy may be indicated.

Similar articles

  • Causes and Evaluation of Mildly Elevated Liver Transaminase Levels
    RC Oh et al. Am Fam Physician 84 (9), 1003-8. PMID 22046940.
    Mild elevations in levels of the liver enzymes alanine transaminase and aspartate transaminase are commonly discovered in asymptomatic patients in primary care. Evidence …
  • [Interpretation of Hypertransaminasemia]
    S Othmani et al. Tunis Med 80 (5), 236-44. PMID 12534025. - Review
    Raised serum level of transaminases aspartate (aminotransferase and alanine aminotransferase) is a frequent situation in medical practice. It is considered as moderate wh …
  • Mildly Elevated Liver Transaminase Levels: Causes and Evaluation
    RC Oh et al. Am Fam Physician 96 (11), 709-715. PMID 29431403.
    Mild, asymptomatic elevations (less than five times the upper limit of normal) of alanine transaminase and aspartate transaminase levels are common in primary care. It is …
  • Special Considerations in Interpreting Liver Function Tests
    DE Johnston. Am Fam Physician 59 (8), 2223-30. PMID 10221307. - Review
    A number of pitfalls can be encountered in the interpretation of common blood liver function tests. These tests can be normal in patients with chronic hepatitis or cirrho …
  • Evaluation of Elevated Liver Enzymes
    TH Lee et al. Clin Liver Dis 16 (2), 183-98. PMID 22541694. - Review
    Liver enzymes, including aminotransferases and alkaline phosphatase, are some of the most commonly ordered blood tests in a physician's practice. These enzymes have been …
See all similar articles

Cited by 54 PubMed Central articles

See all "Cited by" articles

Substances

LinkOut - more resources

Feedback