Causes of Persistently Elevated Alanine Aminotransferase Levels in Patients who Presented to Two Referral Hospitals in Mashhad, Iran during 2011.
BACKGROUND Worldwide, chronic liver disease is a major cause of morbidity and mortality. Causes of elevated serum alanine aminotransferase (ALT) levels vary depending on the population under study. The aim of this study is to evaluate the frequency and causes of persistently elevated ALT levels in patients of the Gastroenterology (GI) Clinics in Ghaem and Emam Reza Hospitals in Mashhad, Iran. METHODS A total of 100 consecutive patients with persistently elevated ALT levels that referred to the GI Clinics at Ghaem and Emam Reza Hospitals in 2011 were studied. Elevated levels were defined as ALT ≥40 U/L at least twice within six months. A comprehensive history that included previous surgeries, transfusion, alcohol consumption and medications was obtained. Patients underwent physical examinations, laboratory analyses and ultrasonography studies. When necessary, liver biopsies were performed. RESULTS Patients' mean age was 44.4 ± 11.83 years. Females comprised 62% of cases. Patients presented with the following conditions: non-alcoholic fatty liver disease (NAFLD, 55%), hepatitis B (17%), autoimmune hepatitis (13%), hepatitis C (4%), autoimmune hepatitis and hepatitis C (2%), overlapping autoimmune disease (2%), Wilson disease (1%), celiac disease (1%), alcoholiche patitis (1%), primary biliary cirrhosis (PBC, 1%), primary sclerosing cholangitis (PSC, 1%), and cryptogenic (2%). CONCLUSION NAFLD was the most common cause of persistently elevated serum ALT levels in this study.
Ghaem Hospital, Mashhad University of Medical Sciences, Mashhad, Iran.
Ahmad
A
Khorashad
Ghaem Hospital, Mashhad University of Medical Sciences, Mashhad, Iran.
Hassan
H
Vossoughinia
Ghaem Hospital, Mashhad University of Medical Sciences, Mashhad, Iran.
Hassan
H
Saadatnia
Emam Reza Hospital, Mashhad University of Medical Sciences, Mashhad.
Abbas
A
Esmaelzadeh
Ghaem Hospital, Mashhad University of Medical Sciences, Mashhad, Iran.
Mitra
M
Ahadi
Ghaem Hospital, Mashhad University of Medical Sciences, Mashhad, Iran.
Mohammad Reza
MR
Farzanehfar
Ghaem Hospital, Mashhad University of Medical Sciences, Mashhad, Iran.
Seyed Mossareza
SM
Hosseini
Department of Community and Public Health, Mashhad University of Medical Sciences, Mashhad, Iran.
Monavvar
M
Afzalaghaii
Nayshabour Faculty of Medical Sciences,Nayshabour, Iran.
Elham
E
Amirmajdi
Mashhad University of Medical Sciences, Mashhad, Iran.
Linda
L
Barari
Tehran University of Medical Sciences, Tehran, Iran.
Farzad
F
Saadatnia
Alanine aminotransferase; Chronic liver disease; Iran; Non-alcoholic fatty liver disease; Viral hepatitis