Elevated liver enzymes
By Mayo Clinic staffOriginal Article: http://www.mayoclinic.com/health/elevated-liver-enzymes/MY00508
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Definition
Elevated liver enzymes may indicate inflammation or damage to cells in the liver. Inflamed or injured liver cells leak higher than normal amounts of certain chemicals, including liver enzymes, into the bloodstream, which can result in elevated liver enzymes on blood tests.
The specific elevated liver enzymes most commonly found are:
- Alanine transaminase (ALT)
- Aspartate transaminase (AST)
Elevated liver enzymes may be discovered during routine blood testing. In most cases, liver enzyme levels are only mildly and temporarily elevated. Most of the time, elevated liver enzymes don't signal a chronic, serious liver problem.
Causes
Many diseases and conditions can contribute to elevated liver enzymes. Your doctor determines the specific cause of your elevated liver enzymes by reviewing your medications, your signs and symptoms and, in some cases, other tests and procedures.
More common causes of elevated liver enzymes include:
- Certain prescription medications, including statin drugs used to control cholesterol
- Drinking alcohol
- Heart failure
- Hepatitis A
- Hepatitis B
- Hepatitis C
- Nonalcoholic fatty liver disease
- Obesity
- Over-the-counter pain medications, including acetaminophen (Tylenol, others)
Other causes of elevated liver enzymes may include:
- Alcoholic hepatitis (liver inflammation caused by drinking alcohol)
- Autoimmune hepatitis (liver inflammation caused by an autoimmune disorder)
- Celiac disease (small intestine damage caused by gluten)
- Cirrhosis (liver scarring)
- Cytomegalovirus (CMV) infection
- Dermatomyositis (inflammatory disease that causes muscle weakness and skin rash)
- Epstein-Barr virus
- Gallbladder inflammation (cholecystitis)
- Heart attack
- Hemochromatosis (too much iron stored in your body)
- Hypothyroidism (underactive thyroid)
- Liver cancer
- Mononucleosis
- Muscular dystrophy (inherited disease that causes progressive muscle weakness)
- Pancreatitis (pancreas inflammation)
- Polymyositis (inflammatory disease that causes muscle weakness)
- Toxic hepatitis (liver inflammation caused by drugs or toxins)
- Wilson's disease (too much copper stored in your body)
When to see a doctor
If a liver function test reveals you have elevated liver enzymes, ask your doctor about what your test results might mean. Your doctor may suggest you undergo other tests and procedures to determine what's causing your elevated liver enzymes.
- Ferri FF. Ferri's Clinical Advisor 2011: Instant Diagnosis and Treatment. Philadelphia, Pa.: Mosby Elsevier; 2011. http://www.mdconsult.com/books/about.do?eid=4-u1.0-B978-0-323-05610-6..C2009-0-38600-6--TOP&isbn=978-0-323-05610-6&about=true&uniqId=230100505-53. Accessed March 11, 2011.
- Pratt DS. Liver chemistry and function tests. In: Feldman M, et al. Sleisenger & Fordtran's Gastrointestinal and Liver Disease: Pathophysiology, Diagnosis, Management. 9th ed. Philadelphia, Pa.: Saunders Elsevier; 2010. http://www.mdconsult.com/books/about.do?eid=4-u1.0-B978-1-4160-6189-2..X0001-7--TOP&isbn=978-1-4160-6189-2&about=true&uniqId=229935664-2192. Accessed March 11, 2011.
- Wilkinson JM (expert opinion). Mayo Clinic, Rochester, Minn. April 13, 2011.
- Green RM, et al. AGA technical review on the evaluation of liver chemistry tests. Gastroenterology. 2002;123:1367.
- Peterson DM (expert opinion). Mayo Clinic, Scottsdale/Phoenix, Ariz. April 14, 2011.
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