Liver Blood Tests (cont.)
What liver diseases cause abnormal aminotransferase
levels?The highest levels of AST and ALT are found with
disorders that cause the death of numerous liver cells
(extensive hepatic necrosis). This occurs in such
conditions as:
- acute viral hepatitis A or B,
- pronounced
liver damage inflicted by toxins as from an
overdose of acetaminophen (brand-name Tylenol), and
- prolonged collapse
of the circulatory system (shock) when the liver is
deprived of fresh blood bringing oxygen and nutrients.
AST
and ALT serum levels in these situations can range anywhere
from ten times the upper limits of normal to thousands of
units/liter.
Mild to moderate elevations of the liver enzymes are
commonplace. They are often unexpectedly encountered on
routine blood screening tests in otherwise healthy
individuals. The AST and ALT levels in such cases are
usually between twice the upper limits of normal and
several hundred units/liter.
One of the most common cause of mild to moderate elevations of
these liver enzymes is fatty liver. In the United States,
the most frequent cause of fatty liver is alcohol abuse.
Other causes of fatty liver include diabetes mellitus and
obesity. Chronic hepatitis C is also becoming an important
cause of mild to moderate liver enzyme elevations.
What medications cause abnormal aminotransferase
levels?A host of medications can cause abnormal liver enzymes
levels.
Examples include:
Pain relief medications such as:
- aspirin,
- acetaminophen (Tylenol),
- ibuprofen (Advil, Motrin),
- naproxen (Naprosyn,
Naprelan, Anaprox, Aleve),
- diclofenac (Voltaren,
Cataflam, Voltaren-XR)),
and
- phenylbutazone (Butazolidine)
Anti-seizure medications such as:
Antibiotics such as:
Cholesterol lowering drugs
such as:
Cardiovascular drugs such as:
Other drugs
Anti-depressant drugs of the tricyclic type
With drug-induced liver enzyme abnormalities, the
enzymes usually normalize weeks to months after stopping
the medications.
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