Approach to Elevated Liver Enzymes

Jessica Rosenberg; Orlando Sola; Adam Visconti

doi:10.1016/j.pop.2023.03.007

Approach to Elevated Liver Enzymes

Prim Care. 2023 Sep;50(3):363-376. doi: 10.1016/j.pop.2023.03.007. Epub 2023 May 16.

Authors

Jessica Rosenberg¹, Orlando Sola², Adam Visconti³

Affiliations

¹ Department of Gastroenterology, MedStar Georgetown University Hospital, 3800 Reservoir Road Northwest, Washington, DC 20007, USA. Electronic address: jessica.j.rosenberg@gunet.georgetown.edu.
² Baltimore, MD, USA.
³ Department of Family Medicine, MedStar Georgetown University, 3800 Reservoir Road Northwest, Washington, DC 20007, USA.

PMID: 37516508
DOI: 10.1016/j.pop.2023.03.007

Abstract

Abnormal liver tests are one of the most common challenges in the primary care setting. Primary care practitioners order these tests for numerous reasons, including investigating abdominal signs and symptoms or suspected alcohol-use disorder, or to determine medication adverse effects. Evaluation should be guided by both the clinical presentation and the pattern of injury. In this article, we will focus on the epidemiology, pathophysiology, clinical presentation, diagnostic work-up, and management of elevated liver enzymes, with an emphasis on the most common causes of abnormal liver testing.

Keywords: Alcohol-associated liver disease; DILI; Drug-induced liver injury; Hepatitis; Liver function tests; NAFLD; Non-alcoholic fatty liver; Transaminitis.

Publication types

Review

MeSH terms

Humans
Liver Diseases* / diagnosis
Liver* / enzymology