TABLE 1

Liver disease and associated liver enzyme elevations

Hepatocellular disease
(aminotransferase elevations predominate)
Common
 Alcoholic liver disease
 Autoimmune hepatitis
 Chronic viral hepatitis
 Genetic hemochromatosis (northern European ethnicity)
 Medication toxicity (see Table 2)
 Nonalcoholic fatty liver disease
Less common
 Alpha-1 antitrypsin deficiency
 Wilson disease
Cholestatic disease
(alkaline phosphatase, bilirubin, and gammaglutamyl transferase elevations predominate)
Common
 Biliary obstruction (eg, gallstones)
 Drug hepatotoxicity
 Neoplasm
 Primary biliary cirrhosis
 Primary sclerosing cholangitis
Less common
 Autoimmune cholangiopathy
 Sarcoidosis
  • From Aragon G, Zounossi ZM. When and how to evaluate mildly elevated liver enzymes in apparently healthy patients. Cleve Clin J Med 2010; 77(3):195–204. doi:10.3949/ccjm.77a.09064.