Asymptomatic persistent non-virus non-alcohol related elevation of aminotransferase levels: a rare case and review of the literature

Gokhan TAZEGUL, Neslihan GUNES, Mete AKIN, Gulsum Ozlem ELPEK, Adil BOZ
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Alanine aminotransferase (ALT) and aspartate aminotransferase
(AST) are found in the liver in their highest concentrations. Two
most common causes of asymptomatic transaminase elevation
are viral infections and alcohol intake. Persistent non-viral nonalcohol
related elevation of aminotransferases indicates that one
or both aminotransferase levels exceed the upper reference limit
for a period of at least 4 weeks. Causes are classified as hepatic;
such as steatosis, autoimmune hepatitis, Wilson’s disease,
hemachromatosis, and nonhepatic; such as celiac disease,
myopathy and hyperthyroidism. Drug use and substance abuse
may also cause an increase in aminotransferase levels. Here, we
report a fifty-eight-year old female patient who had asymptomatic
non-viral non-alcohol related aminotransferase elevation for a year
incidentally diagnosed with malignant infiltration of the liver. It
should be noted that, malignant infiltration of the liver may also be
a rare cause of asymptomatic persistent elevation of transaminases.
Such cases, especially with suspected malignancy should be
evaluated in terms of this condition.
Keywords: Aspartate aminotransferase, Alanine aminotransferase,
Asymptomatic diseases, Incidental findings

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