CMAJ • February 1, 2005; 172 (3). doi:10.1503/cmaj.1040752.
© 2005 Canadian Medical Association or its licensors
All editorial matter in CMAJ represents the opinions of the authors and not necessarily those of the Canadian Medical Association.
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Right arrow Liver (including hepatitis and cirrhosis)

Review
Synthèse

Liver enzyme alteration: a guide for clinicians

Edoardo G. Giannini, Roberto Testa and Vincenzo Savarino

From the Gastroenterology Unit, Department of Internal Medicine, University of Genoa, Genoa, Italy.

Correspondence to: Dr. Edoardo G. Giannini, Gastroenterology Unit, Department of Internal Medicine, University of Genoa, Viale Benedetto XV, no. 6, 16132, Genoa, Italy; fax: 39 010 353 8638; egiannini{at}unige.it

Abstract

ISOLATED ALTERATIONS OF BIOCHEMICAL MARKERS OF LIVER DAMAGE in a seemingly healthy patient can present a challenge for the clinician. In this review we provide a guide to interpreting alterations to liver enzyme levels. The functional anatomy of the liver and pathophysiology of liver enzyme alteration are briefly reviewed. Using a schematic approach that classifies enzyme alterations as predominantly hepatocellular or predominantly cholestatic, we review abnormal enzymatic activity within the 2 subgroups, the most common causes of enzyme alteration and suggested initial investigations.




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