title: When and how to evaluate mildly elevated liver enzymes in apparently healthy patients.
abstract: Because 1% to 9% of people without symptoms have elevated liver enzymes, extensive evaluation of all abnormal test results would expose many patients to undue risks and expenses. On the other hand, failure to evaluate minor liver enzyme elevations could mean missing the early diagnosis of potentially treatable disorders. This review discusses likely causes of elevated aminotransferase, alkaline phosphatase, and gamma-glutamyl transferase levels and provides algorithms for evaluating high liver enzyme values in apparently healthy patients in the primary care setting.
authors.affiliation: Center for Liver Diseases, Inova Fairfax Hospital, Falls Church, VA 22042, USA.
authors.forename: George
authors.initials: G
authors.lastname: Aragon
authors.forename: Zobair M
authors.initials: ZM
authors.lastname: Younossi
mesh_terms: D000465:Algorithms; D000469:Alkaline Phosphatase / Q000097:blood*; D006432:Hemochromatosis / Q000201:enzymology / Q000453:epidemiology; D006801:Humans; D008099:Liver / Q000201:enzymology* / Q000473:pathology; D008105:Liver Cirrhosis, Biliary / Q000201:enzymology / Q000453:epidemiology; D008108:Liver Diseases, Alcoholic / Q000201:enzymology / Q000453:epidemiology; D012307:Risk Factors; D000637:Transaminases / Q000097:blood*; D014481:United States / Q000453:epidemiology; D000515:alpha 1-Antitrypsin / Q000378:metabolism; D005723:gamma-Glutamyltransferase / Q000097:blood*
chemical_list: C043392:SERPINA1 protein, human; D000515:alpha 1-Antitrypsin; D005723:gamma-Glutamyltransferase; D000637:Transaminases; D000469:Alkaline Phosphatase