Incidental hypertransaminasemia in children-a stepwise approach in primary care

被引:4
作者
Costa, Joana Meneses [1 ]
Pinto, Sara Martins [2 ]
Santos-Silva, Ermelinda [3 ,4 ,5 ]
Moreira-Silva, Helena [3 ]
机构
[1] Grp Hlth Ctr Gondomar, Valbom Family Hlth Unit, Porto, Portugal
[2] Grp Hlth Ctr Gondomar, Nascente Family Hlth Unit, Porto, Portugal
[3] Ctr Hosp Univ Porto, Ctr Materno Infantil Norte, Pediat Div, Gastroenterol Unit, Largo Maternidade 45, P-4050651 Porto, Portugal
[4] Univ Porto, Integrated Master Med, Inst Ciencias Biomed Abel Salazar, Porto, Portugal
[5] Univ Porto, Fac Farm, Dept Biol Sci, Lab Biochem,REQUIMTE,UCIBIO, Porto, Portugal
关键词
Elevated liver enzymes; Hypertransaminasemia; Children; Primary care; FATTY LIVER-DISEASE; NORTH-AMERICAN SOCIETY; EPSTEIN-BARR-VIRUS; PEDIATRIC GASTROENTEROLOGY; ALANINE AMINOTRANSFERASE; POSITION PAPER; HEPATOLOGY COMMITTEE; CYSTIC-FIBROSIS; WILSONS-DISEASE; DIAGNOSIS;
D O I
10.1007/s00431-023-04825-4
中图分类号
R72 [儿科学];
学科分类号
100202 ;
摘要
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.
引用
收藏
页码:1601 / 1609
页数:9
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