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Incidental hypertransaminasemia in children—a stepwise approach in primary care

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 sys...

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Autores principales: Costa, Joana Meneses, Pinto, Sara Martins, Santos-Silva, Ermelinda, Moreira-Silva, Helena
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer Berlin Heidelberg 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9877494/
https://www.ncbi.nlm.nih.gov/pubmed/36697884
http://dx.doi.org/10.1007/s00431-023-04825-4
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author Costa, Joana Meneses
Pinto, Sara Martins
Santos-Silva, Ermelinda
Moreira-Silva, Helena
author_facet Costa, Joana Meneses
Pinto, Sara Martins
Santos-Silva, Ermelinda
Moreira-Silva, Helena
author_sort Costa, Joana Meneses
collection PubMed
description 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.
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spelling pubmed-98774942023-01-26 Incidental hypertransaminasemia in children—a stepwise approach in primary care Costa, Joana Meneses Pinto, Sara Martins Santos-Silva, Ermelinda Moreira-Silva, Helena Eur J Pediatr Research 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. Springer Berlin Heidelberg 2023-01-26 2023 /pmc/articles/PMC9877494/ /pubmed/36697884 http://dx.doi.org/10.1007/s00431-023-04825-4 Text en © The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature 2023, Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law. This article is made available via the PMC Open Access Subset for unrestricted research re-use and secondary analysis in any form or by any means with acknowledgement of the original source. These permissions are granted for the duration of the World Health Organization (WHO) declaration of COVID-19 as a global pandemic.
spellingShingle Research
Costa, Joana Meneses
Pinto, Sara Martins
Santos-Silva, Ermelinda
Moreira-Silva, Helena
Incidental hypertransaminasemia in children—a stepwise approach in primary care
title Incidental hypertransaminasemia in children—a stepwise approach in primary care
title_full Incidental hypertransaminasemia in children—a stepwise approach in primary care
title_fullStr Incidental hypertransaminasemia in children—a stepwise approach in primary care
title_full_unstemmed Incidental hypertransaminasemia in children—a stepwise approach in primary care
title_short Incidental hypertransaminasemia in children—a stepwise approach in primary care
title_sort incidental hypertransaminasemia in children—a stepwise approach in primary care
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9877494/
https://www.ncbi.nlm.nih.gov/pubmed/36697884
http://dx.doi.org/10.1007/s00431-023-04825-4
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