All that glitters is not gold: Elevated liver enzymes do not mean liver disease always

2014 ◽  
Vol 33 (5) ◽  
pp. 476-477
Author(s):  
Jeyamani Ramachandran ◽  
K. G. Sajith
Keyword(s):  
Liver Disease ◽  
Liver Enzymes ◽  
Elevated Liver Enzymes

scholarly journals Liver disease in children and Adolescents with Type1 Diabetes Mellitus

QJM ◽  
2020 ◽  
Vol 113 (Supplement_1) ◽  
Author(s):  
M H Elsayed ◽  
M T Hamza ◽  
M M Elsaeed ◽  
R A F Thabet
Keyword(s):  
Diabetes Mellitus ◽  
Type 1 Diabetes ◽  
Liver Disease ◽  
Type 1 Diabetes Mellitus ◽  
Children And Adolescents ◽  
Liver Enzymes ◽  
Rare Complication ◽  
Elevated Liver Enzymes ◽  
Liver Transaminases

Abstract Glycogenic hepatopathy (GH) is a very rare complication seen mostly in patients with type 1 diabetes mellitus (T1DM) in whom glycemic control has been poor for a long time. We assessed liver diseases in children and adolescents with type 1 diabetes mellitus by detection of elevated liver transaminases and confirmed by fibro scan and ultrasound. One hundred and seven children and adolescents with T1DM were subjected to detailed history, physical examination, laboratory investigation and radiological investigation. Liver transaminases, mean HbA1c and pelviabdominal ultrasound were done for all patients while fibro scan for those with elevated liver enzymes only. Patients with elevated liver enzymes were reassessed after one year. Only nine of our patients have elevated liver enzymes. HbA1c and fibro scan abnormalities (F stage) were significantly higher in patients with elevated liver enzymes. (p < 0.001) After follow up a significant decrease in liver enzymes, fibro scan abnormalities and HbA1c in the group with elevated liver enzymes initially was detected. (p < 0.001) We concluded that liver disease is not a common complication in patients with long standing uncontrolled diabetes which can be reversed after proper control.

Challenges in Screening for Pediatric Nonalcoholic Fatty Liver Disease

2017 ◽  
Vol 57 (5) ◽  
pp. 558-562 ◽  
Author(s):  
Anna E. Ferguson ◽  
Stavra A. Xanthakos ◽  
Robert M. Siegel
Keyword(s):  
Liver Disease ◽  
Fatty Liver ◽  
Weight Management ◽  
Fatty Liver Disease ◽  
Liver Enzymes ◽  
Management Program ◽  
Weight Management Program ◽  
Nonalcoholic Fatty Liver ◽  
Elevated Liver Enzymes ◽  
Pediatric Weight Management

Nonalcoholic fatty liver disease (NAFLD) is the most common cause of elevated liver enzymes in children in the United States. Screening for NAFLD in children with obesity is recommended by several published guidelines, but the application of these recommendations in pediatric weight management programs is uncertain. Our study aimed to describe the screening practices for NAFLD in a large pediatric weight management program. During 2014, 1312 patients were seen, with a liver enzyme panel obtained in 847 (64.5%). Only 47/847 (5.5%) had elevated liver enzymes twice the upper limit of normal. Of the 47, 33 (70%) patients had persistently elevated liver enzymes. Of those 33, 22 (67%) had further exclusionary laboratory testing. Screening for NAFLD is challenging even in a pediatric weight management program with clearly established protocols. Those with elevated liver enzymes do not always complete recommended exclusionary testing. Barriers to completing further evaluation need to be addressed.

scholarly journals Potentially hepatotoxic drugs are still being prescribed to liver disease patients under tertiary care: it is time to say enough

2021 ◽  
Vol 5 (4) ◽  
pp. 279-286
Author(s):  
Rodrigo Dorelo ◽  
Samantha T.A. Barcelos ◽  
Magela Barros ◽  
Valeria Elustondo ◽  
Ysela Y.P. Pérez ◽  
...  
Keyword(s):  
Liver Disease ◽  
Hepatitis C ◽  
Liver Enzymes ◽  
Tertiary Care ◽  
University Hospital ◽  
Decompensated Cirrhosis ◽  
Drug Induced ◽  
Alcoholic Fatty Liver ◽  
Drug Induced Liver Injury ◽  
Elevated Liver Enzymes

Introduction and aim: Drug-induced liver injury (DILI) manifests as a spectrum of clinical presentations that carries morbidity and mortality. Patients with chronic liver disease (CLD), particularly hospitalized, are at high risk for developing DILI. We aimed to investigate the use of potentially hepatotoxic drugs (PHD) in patients with CLD in a tertiary university hospital. Materials and methods: Adult (≥ 18 years-old) with CLD admitted to the hospital from January 2016 to December 2018 were evaluated regarding PHD, assessing the risk of DILI and liver enzymes behavior after exposure. Results: From 931 hospitalized patients with CLD, 291 (31.3%) were exposed to hepatotoxic drugs during their hospitalization. Of those, 244 (83.8%) were cirrhotic. The most frequent causes of liver disease were hepatitis C (41.2%), followed by alcohol (13.2%), hepatitis C/alcohol (11.7%) and non-alcoholic fatty liver disease (5.8%). Decompensated cirrhosis (46.7%) was the main reason for hospital admission. The most often prescribed PHD were antibiotics (67.7%), cardiovascular drugs (34.4%), neuromodulators (26.1%) and anesthetics (19.9%). After exposure, 113 patients (38.8%) presented significant elevated liver enzymes. Surprisingly, PHD were more often prescribed in GI/Liver unit (48.8%) followed by emergency/intensive care unit (28.5%). A total of 65 patients (22%) died, however in neither case was it possible to safely infer causal relationship among PHD, liver enzymes and death. Conclusion: PHD prescription is frequent in patients with CLD even in a tertiary university hospital and in the gastroenterology and hepatology department, exposing these patients to an additional risk.

scholarly journals The Role of Liver Biopsy in the Management of Patients with Liver Disease

2003 ◽  
Vol 17 (11) ◽  
pp. 651-654
Author(s):  
Florence Wong
Keyword(s):  
Liver Disease ◽  
Liver Biopsy ◽  
Fatty Liver Disease ◽  
Liver Enzymes ◽  
Histological Evaluation ◽  
Prognostic Information ◽  
Nonalcoholic Fatty Liver ◽  
Elevated Liver Enzymes ◽  
Clinical Diagnoses

The role of liver biopsy in the diagnosis and management of liver disease is a controversial issue even among hepatologists. Although most causes of elevated liver enzymes can be determined, or at least suspected, on the basis of a careful history and laboratory tests, histological assessment remains the gold standard for most liver diseases. Histological evaluation can either confirm or refute clinical diagnoses and can provide information about the severity and stage of disease. Occasionally, the liver biopsy also provides an additional diagnosis. The spectrum of nonalcoholic fatty liver disease accounts for a substantial proportion of cases of chronically elevated liver enzymes and can be reliably diagnosed only by liver biopsy. Prognostic information can be obtained in patients with this disorder, as well as in those with alcoholic liver disease and viral hepatitis, and liver biopsy can be used as a guide to their management.

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