title: Clinical significance of elevated alanine aminotransferase in blood donors: a follow-up study.
abstract: Alanine aminotransferase (ALT) elevation in blood donors can be related to many variables such as viral hepatitis, overweight and ethanol consumption.
  
  
  OBJECTIVE
  This study aims to define factors associated with ALT elevation in candidates for blood donation, to evaluate ALT levels during follow-up, and to establish a histological diagnosis of hepatic disease.
  
  
  METHODS
  Alcoholism, obesity, drug-induced liver disease, diabetes, hemochromatosis and alpha 1-anti-trypsin deficiency were investigated in 119 subjects (113 males, six females, aged 33.4+/-8.4 years) who were hepatitis B surface antigen/anti-hepatitis C virus negative and had been rejected as blood donors as a result of elevated ALT (>1.5 times the upper normal limit (UNL) in two determinations). During follow-up, ALT was determined every 8 weeks and liver biopsy recommended in cases with persistently elevated ALT levels.
  
  
  RESULTS
  Obesity (30.2%) and alcoholism (28.6%) were most frequently associated with ALT elevation and in 9.2% of cases no association was found. ALT levels decreased significantly, regardless of the associated factor. Liver histology in 40 patients showed steatosis (35%), steatohepatitis (30%), non-specific reactive hepatitis (12.5% of cases), normal liver (15% of cases) and alcoholic cirrhosis, hemochromatosis and non-specific portal fibrosis in three cases.
  
  
  CONCLUSIONS
  ALT levels usually dropped during follow-up and although severe hepatic lesions can be found in asymptomatic blood donors, mild hepatic damage is the rule.
authors.affiliation: Department of Pathology, University of São Paulo School of Medicine, São Paulo, Brazil. simatorezan@uol.com.br
authors.forename: Mario Antonio
authors.initials: MA
authors.lastname: Torezan-Filho
authors.forename: Venancio Avancini Ferreira
authors.initials: VA
authors.lastname: Alves
authors.forename: César Almeida
authors.initials: CA
authors.lastname: Neto
authors.forename: Helena Sabino
authors.initials: HS
authors.lastname: Fernandes
authors.forename: Edna
authors.initials: E
authors.lastname: Strauss
mesh_terms: D000328:Adult; D000410:Alanine Transaminase / Q000097:blood*; D000437:Alcoholism / Q000175:diagnosis* / Q000453:epidemiology; D015415:Biomarkers / Q000097:blood; D001707:Biopsy, Needle; D001782:Blood Donors; D001938:Brazil / Q000453:epidemiology; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D008107:Liver Diseases / Q000175:diagnosis* / Q000453:epidemiology; D008297:Male; D009765:Obesity / Q000175:diagnosis* / Q000453:epidemiology; D011336:Probability; D018570:Risk Assessment; D012680:Sensitivity and Specificity
chemical_list: D015415:Biomarkers; D000410:Alanine Transaminase