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Test Findings
 
 

Elevated Aminotransferases

 
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Overview

  • Causes of Elevated Transaminases

  • Hepatocellular Injury

  • Viral hepatitis - A, B, C, E, HSV, EBV, CMV, VZV
  • Alcoholic liver disease - alcoholic hepatitis, steatohepatosis, cirrhosis
  • Non-alcoholic hepatosteatosis (fatty liver disease)
  • Drug or toxin-induced liver disease - paracetamol, NSAIDs, statins, ciprofloxacin, azole antifungals, methotrexate, amiodarone, isoniazid, phenytoin, sulfonylureas, rifampicin, anabolic steroids, cocaine, ecstasy, PCP, glues, solvents, certain herbal remedies
  • Vascular disease - ischaemic hepatitis, portal venous thrombosis, congestive cardiac failure
  • Infiltrative disease - sarcoidosis, amyloidosis, tuberculosis, Hodgin lymphoma, liver metastases
  • Autoimmune liver diseases - autoimmune hepatitis, primary biliary cirrhosis, primary sclerosing cholangitis
  • Haemochromatosis
  • Wilson’s disease
  • Alpha-1 antitrypsin deficiency
  • Hepatocellular carcinoma
  • Non-Hepatic

  • Myopathy - vigorous exercise, myositis
  • Hypothyroidism
  • Coeliac disease
  • Interpretation

  • Mild derangement (<5x normal)Non-alcoholic steatohepatosis, chronic viral hepatitis, liver metastases, drugs
  • Moderate derangement (5-20x normal)Chronic viral hepatitis, alcoholic hepatitis, autoimmune hepatitis
  • Severe derangement (>20x normal)Acute viral hepatitis, drug-induced hepatitis, ischaemic hepatitis
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