| Elevated transaminases | |
|---|---|
 | |
| Alanine transaminase is one of the two transaminases measured (Aspartate transaminase is the other). |
In medicine, the presence of elevated transaminases, commonly the transaminases alanine transaminase (ALT) and aspartate transaminase (AST), may be an indicator of liver dysfunction.[1][2] Other terms include transaminasemia,[3] and elevated liver enzymes (though they are not the only enzymes in the liver). Normal ranges for both ALT and AST vary by gender, age, and geography and are roughly 8-40 U/L (0.14-0.67 μkal/L).[4] Mild transaminesemia refers to levels up to 250 U/L.[1] Drug-induced increases such as that found with the use of anti-tuberculosis agents such as isoniazid are limited typically to below 100 U/L for either ALT or AST. Muscle sources of the enzymes, such as intense exercise, are unrelated to liver function and can markedly increase AST and ALT.[5] Cirrhosis of the liver or fulminant liver failure secondary to hepatitis commonly reach values for both ALT and AST in the >1000 U/L range; however, many people with liver disease have normal transaminases.[6][7] Elevated transaminases that persist less than six months are termed "acute" in nature, and those values that persist for six months or more are termed "chronic" in nature.
- ^ a b Giboney PT (March 2005). "Mildly Elevated Liver Transaminase Levels in the Asymptomatic Patient". Am Fam Physician. 71 (6): 1105–10. PMID 15791889.
- ^ Maddrey, Willis C.; Schiff, Eugene R.; Sorrell, Michael F. (2007). Schiff's diseases of the liver. Hagerstwon, MD: Lippincott Williams & Wilkins. p. 924. ISBN 978-0-7817-6040-9.
- ^ "Transaminasemia: semantic confusion of a clinical dilemma". Calif Med. 114 (6): 45–7. June 1971. PMC 1501958. PMID 5578107.
- ^ Ceriotti, F.; et al. (2010). "Common reference intervals for aspartate aminotransferase (AST), alanine aminotransferase (ALT) and g-glutamyl transferase (GGT) in serum: results from an IFCC multicenter study". Clin Chem Lab Med. 48 (11): 1593–2101. doi:10.1515/CCLM.2010.315. PMID 21034260. S2CID 21929466.
- ^ Pettersson, J.; et al. (2007). "Muscular exercise can cause highly pathological liver function tests in healthy men". British Journal of Clinical Pharmacology. 65 (2): 253–259. doi:10.1111/j.1365-2125.2007.03001.x. PMC 2291230. PMID 17764474.
- ^ Hall, Philip; Cash, Johnny (January 2012). "What is the Real Function of the Liver 'Function' Tests?". The Ulster Medical Journal. 81 (1): 30–36. ISSN 0041-6193. PMC 3609680. PMID 23536736.
- ^ Lominadze, Zurabi; Kallwitz, Eric R. (October 2018). "Misconception: You Can't Have Liver Disease With Normal Liver Chemistries". Clinical Liver Disease. 12 (4): 96–99. doi:10.1002/cld.742. PMC 6385914. PMID 30988921.