Hypertransaminasemia: Is it Always Liver Disease? The Case of Subclinical Myopathies and Macroenzymes – Pages 8-17

Claudio Veropalumbo, Roberta D’Aniello, Maria Sangermano, Giulia Paolella and Pietro Vajro

1Department of Translational Medical Sciences, Pediatrics, Medical School of the University of Naples "Federico II", Naples, Italy; 2Chair of Pediatrics, Department of Medicine and Surgery, Medical School of the University of Salerno, Salerno, Italy

DOI: http://dx.doi.org/10.12970/2308-6483.2013.01.01.3

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Abstract: Aminotransferases increase in serum is generally considered indicative of liver cell injury. However, these enzymes are also present in tissues other than the liver, mainly the muscles. Therefore, after an incidental finding of hypertransaminasemia, serum creatine kinase check and an accurate physical examination -looking for subtle signs of muscular affection- are necessary to reach a correct diagnosis and avoid missing salient signs of a muscular disorder.

In the case of protracted isolated AST elevation, the possibility of macro-AST should be taken into account as well. This is a generally benign condition, whose prompt recognition might avoid expensive, and occasionally invasive liver disease-related diagnostic procedures. Polyethylene glycol testing is considered a valuable screening test.

Keywords: Hypertransaminasemia, Transaminase, Aspartate Aminotransferase, Alanine Aminotransferase, Myopathy, Dystrophinopaty, Macro-aspartate aminotransferasemia. Read more