In this Article

• Introduction to liver blood test
• What are the aminotransferases?
• Normally, where are the aminotransferases?
• What are normal levels of AST and ALT?
• What do elevated AST and ALT mean?
• What liver diseases cause abnormal aminotransferase levels?
• What medications cause abnormal aminotransferase levels?
• What are less common causes of abnormal aminotransferase levels?
• How are healthy people evaluated for mild to moderate rises in aminotransferase levels?
• How about monitoring aminotransferase levels?
• What about other liver enzymes?
• Patient Discussions: Liver Blood Tests - Helped With Your Diagnosis
• Liver Blood Tests Index

What are less common causes of abnormal aminotransferase levels?

Less common causes of abnormal liver enzymes in the United States include chronic hepatitis B, hemachromatosis (iron overload), Wilson's disease, alpha-1-antitrypsin deficiency, celiac sprue, Crohn's disease, ulcerative colitis, and autoimmune hepatitis. Though not as common as hepatitis C, hepatitis B can cause chronic liver disease with persistently abnormal liver enzymes.

• Hemachromatosis is a genetic (inherited) disorder in which there is excessive absorption of dietary iron leading to accumulation of iron in the liver with resultant inflammation and scarring of the liver.
  
  
• Wilson's disease is an inherited disorder with excessive accumulation of copper in diverse tissues including the liver and the brain. Copper in liver can lead to chronic liver inflammation, while copper in brain can cause psychiatric and motor disturbances.
  
  
• Alpha-1-antitrypsin deficiency is an inherited disorder in which the lack of a glycoprotein (carbohydrate-protein complex) called alpha-1-antitrypsin lead to chronic lung disease (emphysema) and to liver disease.
  
  
• Autoimmune hepatitis results from liver injury brought about by the body's own antibodies and defense systems attacking the liver.
  
  
• Celiac sprue is a small intestinal illness where a patient has allergy to gluten and develops gas, bloating, diarrhea, and in advanced cases malnutrition. Patients' with celiac sprue can also develop mildly abnormal ALT and AST levels.
  
  
• Crohn's disease and ulcerative colitis are diseases with chronic inflammation of the intestines. In these patients inflammation of the liver (hepatitis) or bile ducts (primary sclerosing cholangitis) also can occur, causing abnormal liver tests.

Rarely, abnormal liver enzymes can be a sign of cancer in the liver. Cancer arising from liver cells is called hepatocellular carcinoma or hepatoma. Cancers spreading to the liver from other organs (such as colon, pancreas, stomach, etc) are called metastatic malignancies.

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