Systematic Approach to the Patients with Elevated Liver Transaminase

Hepatic transaminase tests are the primary tests of standard laboratory panels in outpatients or emergent cases. In this retrospective study, epidemiological, clinical, and laboratory data of 223 patients who were hospitalized for elevated transaminase levels and acute liver damage between January 2004 and January 2009 were evaluated. The most frequently encountered viral cause of elevated transaminases was acute hepatitis B (HBV) (51%) infection. This was followed by acute hepatitis A (HAV) (30%), acute hepatitis C (HCV) (1%), delta co-infection (1%), and HAV plus HBV co-infections (0.5%). Other causes were alcoholic hepatitis (2%), acute cholecystitis and choledocholithiyasis (1.5%), and ischemic hepatitis due to congestive heart failure (1%). No causative factor was detected in 11% of the patients. Elevations in liver transaminas levels are common in routine practices, and should be evaluated accurately based on revised current knowledge in order to make correct diagnosis since they may reflect many underlying conditions. In the present study, the clinical conditions led to moderate and marked elevations in liver transaminase levels were indicated and the requirement of a systematic approach to these patients for the diagnosis was emphasized