Since the transaminases and alkaline phosphatase are part of routine laboratory tests, pathological deviations are often seen in patients who have no clinical signs nor symptoms of liver diseases. In these patients, the physician should have a history of conduct with regard to possible hepatotoxic substances incl. Alcohol, prescription and non-prescription drugs, herbal teas, remedies and environmental and other chemical substances.

See also liver structure and function and assessment of patients with liver disease.) Since the transaminases and alkaline phosphatase are part of routine laboratory tests, are often seen pathological abnormality in patients who have no clinical signs nor symptoms of liver diseases. In these patients, the physician should have a history of conduct with regard to possible hepatotoxic substances incl. Alcohol, prescription and non-prescription drugs, herbal teas, remedies and environmental and other chemical substances. Aminotransferases With a slight and isolated elevation of alanine aminotransferase or aspartate aminotransferase (<2 times below normal), the test should be repeated; in a third of cases the result is not confirmed. If changes in other laboratory values ??are difficult or persist more testing, more tests are displayed: A fatty liver should be considered; often they can be clinically detected. Patients should be screened for hepatitis B and C. Patients> 40 should be screened for hemochromatosis. Patients <30 should be tested for Wilson's disease. Most patients, especially young or middle-aged women should be screened for autoimmune diseases. Risk patients was tested for malaria and schistosomiasis one. If until now all the results are negative, screening may be indicated on an alpha 1-antitrypsin deficiency. Leads the whole series of tests to no result, a liver biopsy should be considered. Alkaline phosphatase The isolated increase of alkaline phosphatase in an asymptomatic patient requires securing a hepatic origin by a simultaneous increase of 5'-nucleotidase or gamma-glutamyl transferase. When the hepatic origin is secured, imaging of the liver, usually ultrasonography and magnetic resonance cholangiopancreatography are indexed. Show the imaging no structural changes, the presence of intrahepatic cholestasis is even suspected case of a positive drug or toxin medical history or possible. Infiltrative disease and liver metastases (z. B. as a result of colon cancer) should also be considered. In women antimitochondrial antibodies must be determined to test for primary biliary cirrhosis. In permanently existing, unexplained increases or suspected intrahepatic cholestasis, a liver biopsy should be discussed.

Health Life Media Team

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