Elevated ALT and AST in an asymptomatic person, what the primary care doctor should do?

  • Keng Yin Loh

Abstract

• Abnormal liver function test with raised alanine aminotransferase (ALT) and raised aspartate aminotransferase (AST)are commonly seen in primary care setting.

• Chronic alcohol consumption, drugs, non-alcoholic steatohepatitis (NASH) and chronic viral hepatitis are commoncauses associated with raised ALT and AST.

• In chronic viral hepatitis, the elevation of liver enzyme may not correlate well with the degree of liver damage.

• Non-hepatic causes of raised ALT and AST include polymyositis, acute muscles injury, acute myocardial infarctionand hypothyroidism.• In the primary care setting, the doctor should obtain a complete history regarding the risk factors for viral hepatitis,substance abuse and request investigations accordingly.

• Suspected chronic viral hepatitis and liver cirrhosis are best referred to hepatologist for further management

References

Giannini EG, Testa R, Savarino V. Liver enzyme alteration: a

guide for clinicians. CMAJ. 2005;172(3):367-79.

Giboney PT. Mildly elevated liver transaminase levels in the

asymptomatic patient. Am Fam Physician. 2005;71(6):1105-

Green RM, Flamm S. AGA technical review on the evaluation

of liver chemistry tests. Gastroenterology. 2002;123(4):1367-

Published
2009-10-01
How to Cite
LohK. Y. (2009). Elevated ALT and AST in an asymptomatic person, what the primary care doctor should do?. Malaysian Family Physician, 4(2 & 3), 2. Retrieved from https://www.e-mfp.org/ojs3/index.php/MFP/article/view/187
Section
Original Articles