The apparently well patient with chronically elevated aminotransferase levels
is a medical challenge. A knowledge of the differential diagnosis permits rational
investigation in such cases.
The causes of asymptomatic chronically elevated
aminotransferase activity include:
- alcohol abuse
chronic hepatitis: B and C
- steatosis and non-alcoholic steatosis
fatty liver disease (NAFLD) includes a wide spectrum of liver pathology, ranging
from fatty liver alone to the more severe nonalcoholic steatohepatitis (1)
is the most common cause of chronically elevated LFTs in the United States in
both diabetic and nondiabetic individuals
- with respect to patients with
NAFLD, 60-95% are obese, 28-55% have type 2 diabetes, and 20-92% have hyperlipidemia
- autoimmune hepatitis
- alpha1-antitrypsin deficiency
- coeliac disease
- inherited and acquired muscle
P. Nonalcoholic fatty liver disease. N Engl J Med 2002;346: 1221-31.
EH.Elevated Liver Function Tests in Type 2 Diabetes.Clinical Diabetes 2005; 23:115-119.