title: [Unexplained, subclinical chronically elevated transaminases].
abstract: Unexplained, subclinical chronically elevated transaminases is mainly a marker of non-alcoholic fatty liver disease, metabolic syndrome, alcoholism and diabetes, which are very common situations but viral hepatitis and iatrogenic origin must also be considered. Before looking for hepatic or genetic rare diseases, it is worth considering hypertransaminasemia as a clue for muscular disease, particularly in paediatric settings, and creatine phosphokinase is a specific marker. Then, patient history, examination and appropriate biologic requests can permit the identification of less frequent disorders where isolated hypertransaminasemia is possibly the unique marker of the disease for a long while: hemochromatosis, celiac disease, autoimmune hepatitis, Wilson's disease, α1-anti-trypsine deficiency, thyroid dysfunctions, Addison's disease. Liver biopsy should be performed only in patients with aspartate aminotransferases upper the normal range or alanine aminotransferases higher than twice the normal range after 6 months delay with dietetic corrections.
authors.affiliation: Service de médecine interne, centre hospitalier Lyon-Sud, université de Lyon, Pierre Bénite cedex, France. denis.vital-durand@chu-lyon.fr
authors.forename: D
authors.initials: D
authors.lastname: Vital Durand
authors.forename: J-C
authors.initials: JC
authors.lastname: Lega
authors.forename: T
authors.initials: T
authors.lastname: Fassier
authors.forename: T
authors.initials: T
authors.lastname: Zenone
authors.forename: I
authors.initials: I
authors.lastname: Durieu
mesh_terms: D000437:Alcoholism / Q000097:blood / Q000175:diagnosis; D058070:Asymptomatic Diseases; D056486:Chemical and Drug Induced Liver Injury / Q000097:blood / Q000175:diagnosis; D002908:Chronic Disease; D003937:Diagnosis, Differential; D005234:Fatty Liver / Q000097:blood / Q000175:diagnosis; D006801:Humans; D008659:Metabolic Diseases / Q000097:blood / Q000175:diagnosis*; D065626:Non-alcoholic Fatty Liver Disease; D000637:Transaminases / Q000097:blood*; D015854:Up-Regulation; D014777:Virus Diseases / Q000097:blood / Q000175:diagnosis
chemical_list: D000637:Transaminases
keywords: Alcoholism; Alcoolisme; Elevated transaminases; Hypertransaminasémie; Hépatite médicamenteuse; Iatrogenic liver disease; Non-alcoholic fatty liver disease; Stéatose hépatique non alcoolique