Evaluations of plasma levels of acid phosphatase, alkaline phosphatase, alanine transaminase
and aspartate transaminase
Therefore, it may be worthwhile to monitor patients for cardiac abnormalities despite signs of improving transaminases
. In the case reported by Park et al.
Soon after treatment was started, however, his transaminases
New American College of Gastroenterology Guidelines for Transaminases
Tissue transglutaminase (TG) and IgA endomysiumspecific antibodies (EMAs) were evaluated for the CD because of the growth failure and elevated transaminase
increased again (ALT 466 IU/L and AST 656 IU/L; normal alkaline phosphatase) and a mild hypergammaglobulinaemia (1580 mg/dL) with normal IgA levels (135 mg/dL), positive anti-nuclear (ANA 1/80), anti-neutrophil cytoplasmic (ANCA 1/80), smooth-muscle (ASMA 1/40), and F-actin (23.3 U) antibody were detected, raising the suspicion of drug-induced autoimmune hepatitis.
On day 1 the values were as follows: serum bilirubin total: 2.9 mg%, direct fraction: 1 mg%, serum glutamic-oxaloacetic transaminase
(SGOT): 3,093 units/L, serum glutamic-pyruvic transaminase
(SGPT): 1,573 units/L, serum alkaline phosphatase (ALP): 85 units/L, serum total protein 6.8 g%, albumin: 3.6 g%, prothrombin time 7 s more than the control, and International Normalized Ratio = 1.55.
If alanine or aspartate transaminases
are more than three times the upper limits of normal in asymptomatic patients without any other liver abnormalities, the enzymes should be rechecked within a week and statins should be stopped temporarily if the enzymes are still elevated.
Several studies report that the prevalence of the elevated transaminases
in children varies according to the region, food, sanitation, the period of year and the quality of healthcare.
are raised two to tenfold depending upon the severity of the disease.
INH hepatotoxicity is a common complication of anti- tuberculosis therapy, ranging in severity from asymptomatic elevation of serum transaminases
to hepatic failure.
Despite their efficacy, common side effects including creatine phosphokinase (CPK) elevations, fatigue, weakness, myalgia, liver transaminases
increase and rhabdomyolysis contribute to low adherence to treatment.