Hypertransaminasemia in childhood as a marker of genetic liver disorders

Raffaele Iorio, Angela Sepe, Antonietta Giannattasio, Francesco Cirillo, Angela Vegnente

Research output: Contribution to journalArticle

Abstract

Background. The widespread use of routine biochemical assays has led to increased incidental findings of hypertransaminasemia. We aimed to evaluate the prevalence of different causes of raised aminotransferase levels in children referred to a university department of pediatrics. Methods. We investigated 425 consecutive children (age range, 1-18 years) with isolated hypertransaminasemia. All patients had raised aminotransferase levels on at least two occasions in the last month before observation. Cases due to major hepatotropic viruses were excluded. Results. During the first 6 months of observation, 259 children showed normalized liver enzymes. Among the remaining 166 patients with hypertransaminasemia lasting for more than 6 months, 75 had obesity-related liver disease; 51, genetic disorders; 7, autoimmune hepatitis; 5, cholelithiasis; 3, choledochal cyst; and 3, celiac disease. Among the 51 children with genetic disorders, 18 had Wilson disease; 14, muscular dystrophy; 4, alpha-1-antitrypsin deficiency; 4, Alagille syndrome; 4, hereditary fructose intolerance; 3, glycogen storage disease (glycogenosis IX); 2, ornithine transcarbamylase deficiency; and 2, Shwachman's syndrome. In 22 children, the hypertransaminasemia persisted for more than 6 months in the absence of a known cause. Conclusions. Genetic disease accounted for 12% of cases of isolated hypertransaminasemia observed in a tertiary pediatric department. A high level of suspicion is desirable for an early diagnosis of these disorders, which may present with isolated hypertransaminasemia and absence of typical clinical signs.

Original languageEnglish
Pages (from-to)820-826
Number of pages7
JournalJournal of Gastroenterology
Volume40
Issue number8
DOIs
Publication statusPublished - Aug 2005

Keywords

  • Children
  • Cryptogenic hepatitis
  • Metabolic diseases
  • Transaminases

ASJC Scopus subject areas

  • Gastroenterology

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