title: Liver enzyme alteration: a guide for clinicians.
abstract: Isolated alterations of biochemical markers of liver damage in a seemingly healthy patient can present a challenge for the clinician. In this review we provide a guide to interpreting alterations to liver enzyme levels. The functional anatomy of the liver and pathophysiology of liver enzyme alteration are briefly reviewed. Using a schematic approach that classifies enzyme alterations as predominantly hepatocellular or predominantly cholestatic, we review abnormal enzymatic activity within the 2 subgroups, the most common causes of enzyme alteration and suggested initial investigations.
authors.affiliation: Gastroenterology Unit, Department of Internal Medicine, University of Genoa, Genoa, Italy. egiannini@unige.it
authors.forename: Edoardo G
authors.initials: EG
authors.lastname: Giannini
authors.forename: Roberto
authors.initials: R
authors.lastname: Testa
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Savarino
mesh_terms: D000410:Alanine Transaminase / Q000097:blood*; D000469:Alkaline Phosphatase / Q000097:blood*; D001219:Aspartate Aminotransferases / Q000097:blood*; D001663:Bilirubin / Q000097:blood; D005260:Female; D006801:Humans; D008099:Liver / Q000201:enzymology*; D008107:Liver Diseases / Q000175:diagnosis* / Q000201:enzymology; D008111:Liver Function Tests; D008297:Male; D011517:Prothrombin Time; D012016:Reference Values; D012709:Serum Albumin / Q000032:analysis; D005723:gamma-Glutamyltransferase / Q000097:blood
chemical_list: D012709:Serum Albumin; D005723:gamma-Glutamyltransferase; D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase; D000469:Alkaline Phosphatase; D001663:Bilirubin