Clinical

High aminotransferase levels generally benign in children

Last Updated: 2007-12-25 7:20:25 -0400 (Reuters Health)

By David Douglas

NEW YORK (Reuters Health) - Although the underlying mechanism has not been established, it appears that isolated elevation of serum aminotransferases is generally benign and need not be a cause for immediate action in most young patients, according to Israeli researchers.

"Findings of prolonged abnormal liver enzymes are not rare in infants and young children," senior investigator Dr. Ron Shaoul told Reuters health. "We found that as long as these abnormal enzymes are isolated and are without cholestatic markers -- such as jaundice for example -- these infants and children can be followed conservatively without need for a liver biopsy in most cases."

In the December issue of the Archives of Disease in Childhood, Dr. Shaoul of Bnai Zion Medical center, Haifa and colleagues describe an analysis of 72 apparently healthy babies and young children. All had isolated elevation of serum aminotransferases to at least 1.5 times the norm for their age, for a minimum of 3 months.

The median duration was 11.5 months, during which time creatine phosphokinase, gamma glutamyltransferase, alkaline phosphatase and bilirubin remained normal.

Seven children had liver biopsies performed. Although three were suspected of having a glycogen storage disease, this was not confirmed enzymatically. Four biopsies showed non-specific histological changes.

In most of these children, Dr. Shaoul continued, "the abnormality resolves within a year." However, he concluded, "the exact etiology for this prolonged abnormality is still unclear."

Arch Dis Child 2007;92:1109-1112.