Incidental hypertransaminasemia in children-a stepwise approach in primary care.
Eur J Pediatr
; 182(4): 1601-1609, 2023 Apr.
Article
in En
| MEDLINE
| ID: mdl-36697884
ABSTRACT
Children with elevated liver enzymes are occasionally discovered through laboratory work-up from different clinical scenarios. Although the majority will have transient and/or benign conditions, a subgroup will have underlying liver disorders. The differential diagnosis is broad and therefore, a systematic approach is of utmost importance. In this article, we reviewed the most recent and relevant literature to provide a comprehensive overview of the main disease processes that cause hypertransaminasemia in children. Ultimately, we propose a practical stepwise approach to guide primary care physicians in the evaluation of abnormal liver enzymes in asymptomatic children. The first step is to obtain a complete history along with a thorough physical examination to exclude red flags, which should dictate urgent consultation with a paediatric gastroenterologist or hepatologist. Conclusion:
Hypertransaminasemia is a challenging scenario in the primary care setting. The aetiology can be broad, ranging from hepatic and extrahepatic to transient versus chronic liver disease. Timely referral to a specialised centre is of paramount importance for conducting targeted research and to not miss the chance of identifying a progressive, but still asymptomatic, treatable liver disease. What is Known ⢠Elevated liver enzyme is a challenging scenario in the primary care setting. ⢠There are few studies guiding the evaluation of asymptomatic hypertransaminasemia in the paediatric population and a standardised approach is lacking. What is New ⢠We propose a practical stepwise approach to guide primary care physicians in the evaluation of abnormal liver enzymes.Key words
Full text:
1
Database:
MEDLINE
Main subject:
Liver Diseases
Type of study:
Diagnostic_studies
/
Prognostic_studies
Limits:
Child
/
Humans
Language:
En
Year:
2023
Type:
Article