Liver enzyme elevation and normal pulmonary function in an adult with a declining forced expiratory volume in 1 second.
This article presents a case report of a 41-year-old male firefighter with cholecystitis and a history of mildly elevated alanine aminotransferase. Liver biopsy showed periodic acid Schiff-positive, diastase-resistant periportal globules. Retrospective review of clinical data revealed progressive lung function decline despite absent pulmonary symptoms and normal pulmonary function testing. The following disorders should be considered in any patient with elevated transaminases without an apparent etiology: viral hepatitides, medication toxicity, autoimmune hepatitis, alcohol-induced hepatic injury, and alpha-1-antitrypsin deficiency.
Division of Allergy and Immunology, The Pennsylvania State University Milton S. Hershey Medical Center, Hershey, Pennsylvania, USA. nrider@psu.edu
Nicholas L
NL
Rider
Timothy J
TJ
Craig
D000328:Adult; D000410:Alanine Transaminase / Q000378:metabolism; D002528:Cerebellar Neoplasms / Q000175:diagnosis* / Q000473:pathology; D004198:Disease Susceptibility; D041882:Emphysematous Cholecystitis / Q000097:blood / Q000201:enzymology / Q000209:etiology / Q000473:pathology; D005541:Forced Expiratory Volume / Q000502:physiology*; D005909:Glioblastoma / Q000175:diagnosis* / Q000473:pathology; D006801:Humans; D008099:Liver / Q000201:enzymology / Q000473:pathology; D008297:Male; D009784:Occupational Diseases / Q000097:blood; D016273:Occupational Exposure / Q000009:adverse effects; D010503:Periodic Acid-Schiff Reaction; D011110:Polymorphism, Genetic; D011656:Pulmonary Emphysema / Q000097:blood / Q000235:genetics; D015208:Smoke Inhalation Injury; D000515:alpha 1-Antitrypsin / Q000096:biosynthesis* / Q000235:genetics*
D000515:alpha 1-Antitrypsin; D000410:Alanine Transaminase