title: [Elevated transaminases - what to do if everything was done?].
abstract: Transaminases, gamma-GT and alcalic phosphatase are classically termed as liver enzymes, however they can be found in almost every organ. Elevated levels of the transaminases ALAT (alanin-aminotransferase) and ASAT (aspartat-aminotransferase) are signs of disturbed permeability of the cells, in which these enzymes can be found. In contrast to ALAT, which is mainly liver-specific, the ASAT is found in other organs as well, e.g. heart and skeletal muscle. At a mild elevation of these enzymes a reevaluation is recommended, however if an elevation persists and is suspicious for a liver disease, a specific work up is necessary. In this manuscript, we discuss often overlooked problems and provide a diagnostic algorithm for the workup of elevated liver enzymes.
authors.affiliation: Klinik für Allgemeine Innere Medizin, Universitätsspital Bern (Inselspital), Bern, Germany.
authors.forename: P M
authors.initials: PM
authors.lastname: Lepper
authors.forename: J-F
authors.initials: JF
authors.lastname: Dufour
mesh_terms: D000309:Adrenal Insufficiency / Q000175:diagnosis / Q000201:enzymology; D000328:Adult; D000410:Alanine Transaminase / Q000097:blood*; D000465:Algorithms; D001219:Aspartate Aminotransferases / Q000097:blood*; D001706:Biopsy; D015992:Body Mass Index; D025065:Borrelia burgdorferi; D002446:Celiac Disease / Q000175:diagnosis / Q000201:enzymology*; D003937:Diagnosis, Differential; D005234:Fatty Liver / Q000175:diagnosis / Q000201:enzymology*; D005260:Female; D006333:Heart Failure / Q000175:diagnosis / Q000201:enzymology; D006801:Humans; D006980:Hyperthyroidism / Q000175:diagnosis / Q000201:enzymology; D007037:Hypothyroidism / Q000175:diagnosis / Q000201:enzymology; D008099:Liver / Q000201:enzymology* / Q000473:pathology; D008193:Lyme Disease / Q000175:diagnosis / Q000201:enzymology; D008297:Male; D011446:Prospective Studies; D012282:Rickettsia Infections / Q000175:diagnosis / Q000201:enzymology; D012891:Sleep Apnea Syndromes / Q000175:diagnosis / Q000201:enzymology*
chemical_list: D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase