Prescribing physicians and emergency room physicians should be aware of conditions which may cause a decreased threshold for intoxication.
Alanine aminotransferase (ALT) and aspartate aminotransferase (AST) are found in the liver in their highest concentrations. Two most common causes of asymptomatic transaminase elevation are viral infections and alcohol intake. Persistent non-viral nonalcohol related elevation of aminotransferases indicates that one or both aminotransferase levels exceed the upper reference limit for a period of at least 4 weeks. Causes are classified as hepatic; such as steatosis, autoimmune hepatitis, Wilson's disease, hemachromatosis, and nonhepatic; such as celiac disease, myopathy and hyperthyroidism. Drug use and substance abuse may also cause an increase in aminotransferase levels. Here, we report a fifty-eight-year old female patient who had asymptomatic non-viral non-alcohol related aminotransferase elevation for a year incidentally diagnosed with malignant infiltration of the liver. It should be noted that, malignant infiltration of the liver may also be a rare cause of asymptomatic persistent elevation of transaminases. Such cases, especially with suspected malignancy should be evaluated in terms of this condition. Keywords: Aspartate aminotransferase, Alanine aminotransferase, Asymptomatic diseases, Incidental findings ÖZAlanin aminotransferaz (ALT) ve aspartat aminotransferaz (AST) en yüksek konsantrasyonlarda karaciğerde bulunur. Asemptomatik transaminaz yüksekliğinin en sık iki sebebi viral enfeksiyonlar ve alkol kullanımıdır. Virüs ve alkol ilişkisi olmadan persistan aminotransferans yüksekliği, tanımlanır. Bu yüksekliğe, steatoz, otoimmün hepatit, Wilson hastalığı, hemokromatoz gibi hepatik kaynaklı nedenler ve çölyak hastalığı, miyopati ve hipertiroidizm gibi hepatik olmayan nedenler sebep olabilir. İlaç kullanımı ve uyuşturucu madde kullanımı da aminotransferaz yüksekliğine sebep olabilir. Bu vakada elli sekiz yaşında kadın bir hasta sunmaktayız. Hastanın non-virüs non-alkol sebepli 1 yıl süren aminotransferaz yüksekliği mevcut olup hasta insidental olarak malin karaciğer infiltrasyonu tanısı almıştır. Karaciğerin malin infiltrasyonunun da persistan asemptomatik transaminaz yüksekliğine sebep olabileceği unutulmamalıdır. Bu tarz hastalarda, özellikle malinite şüphesi olan vakalar bu yönden de değerlendirilmelidir.
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