Journal of Clinical and Translational Hepatology

Journal of Clinical and Translational Hepatology

Friday, 09 / 21 / 2018

Articles

Elevated Liver Enzymes in Asymptomatic Patients – What Should I Do?

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Elevated Liver Enzymes in Asymptomatic Patients – What Should I Do?

Mazyar Malakouti*,1, Archish Kataria*,2, Sayed K. Ali3 and Steven Schenker1

1Division of Gastroenterology and Nutrition, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
2Department of Internal Medicine, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
3Department of Internal Medicine, University of Central Florida, College of Medicine, Orlando, FL, USA

*Correspondence to: Archish Kataria, Department of Internal Medicine, University of Texas Health Science Center at San Antonio, 7703 Floyd Curl Drive, MC 7878, San Antonio, TX 78229, USA. Tel: +1-210-665-7038, Fax: +1-210-567-4856, E-mail: This email address is being protected from spambots. You need JavaScript enabled to view it. ; Mazyar Malakouti, Division of Gastroenterology and Nutrition, University of Texas Health Science Center at San Antonio, 7703 Floyd Curl Drive, MC 7878, San Antonio, TX 78229, USA. Tel: +1-204-803-2523, Fax: +1-210-567-4856, E-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.

Journal of Clinical and Translational Hepatology 2017;5(4):394-403 DOI: 10.14218/JCTH.2017.00027

Received: April 24, 2017 Accepted: July 12, 2017 Published online: September 21, 2017

Abstract

Elevated liver enzymes are a common scenario encountered by physicians in clinical practice. For many physicians, however, evaluation of such a problem in patients presenting with no symptoms can be challenging. Evidence supporting a standardized approach to evaluation is lacking. Although alterations of liver enzymes could be a normal physiological phenomenon in certain cases, it may also reflect potential liver injury in others, necessitating its further assessment and management. In this article, we provide a guide to primary care clinicians to interpret abnormal elevation of liver enzymes in asymptomatic patients using a step-wise algorithm. Adopting a schematic approach that classifies enzyme alterations on the basis of pattern (hepatocellular, cholestatic and isolated hyperbilirubinemia), we review an approach to abnormal alteration of liver enzymes within each section, the most common causes of enzyme alteration, and suggest initial investigations.

Keywords

Elevated liver enzymes, Aminotransferase elevation, Liver function tests, Evaluation of abnormal liver enzymes, Approach to alteration of liver enzymes

 

Journal of Clinical and Translational Hepatology 2017 vol. 5, 277-296 Html ] [ PDF Full-text ]

© The Authors 2017. This article is published under the terms of the Creative Commons Attribution-Noncommercial License (CC BY-NC 4.0), which permits use, distribution, and reproduction in any medium, provided the original work is properly cited, the use is non commercial and is otherwise in compliance with the license.

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