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dc.contributor.authorBjörnsson, Helgi Kristinn
dc.contributor.authorOlafsson, Sigurdur
dc.contributor.authorBergmann, Ottar M
dc.contributor.authorBjörnsson, Einar S
dc.date.accessioned2016-06-13T16:12:00Zen
dc.date.available2016-06-13T16:12:00Zen
dc.date.issued2016en
dc.date.submitted2016en
dc.identifier.citationA prospective study on the causes of notably raised alanine aminotransferase (ALT). 2016, 51 (5):594-600 Scand. J. Gastroenterol.en
dc.identifier.issn1502-7708en
dc.identifier.pmid26653080en
dc.identifier.doi10.3109/00365521.2015.1121516en
dc.identifier.urihttp://hdl.handle.net/2336/612816en
dc.descriptionTo access publisher's full text version of this article click on the hyperlink at the bottom of the pageen
dc.description.abstractHigh levels of alanine aminotransferase (ALT) can be a marker of severe liver disease with variable aetiologies and prognosis. Very few prospective studies have been undertaken on the aetiology and prognosis of patients with high ALT levels. No population-based prospective study has systematically evaluated drug-induced liver injury (DILI) among these patients. The objective was to determine the aetiology and prognosis of patients with high ALT.
dc.description.abstractIn a catchment area of 160,000 inhabitants, a population-based prospective study identified all adult patients with serum level of ALT >500 U/L during a 12-month period. All underwent thorough diagnostic work-up and follow-up. In suspected DILI, causality was assessed with Roussel Uclaf Causality Assessment Method.
dc.description.abstractA total of 155 patients were identified with ALT >500 U/L, 12 children and one with ALT of non-liver-related origin, leaving 142 patients for the analysis: 73 (51%) males, median age 52 (IQR 36-68, range 19-89 years). The most common causes were choledocholithiasis 48/142 (34%), ischaemic hepatitis 26 (18%), viral hepatitis 16 (11%) and DILI 15 (11%), hepatobiliary malignancy (n = 6), surgery/interventions (n = 8) and other aetiologies (n = 23). No specific aetiology was found in 6% of cases. In the total study cohort 99 (70%) required hospitalisation, 78 (55%) had jaundice and 22 (16%) died, liver-related death in 10%, 35% in IH and 7% in DILI.
dc.description.abstractThe most common cause of notably high ALT was choledocholithiasis. Ischaemic hepatitis was a common aetiology with approximately 35% liver-related mortality. Viral hepatitis and DILI were important aetiologies among these patients.
dc.description.sponsorshipNational University Hospital of Iceland University of Iceland Research Funden
dc.language.isoenen
dc.publisherTaylor & Francis Ltden
dc.relation.urlhttp://dx.doi.org/ 10.3109/00365521.2015.1121516en
dc.relation.urlhttp://www.tandfonline.com/doi/pdf/10.3109/00365521.2015.1121516en
dc.rightsArchived with thanks to Scandinavian journal of gastroenterologyen
dc.subjectGAS12
dc.subject.meshAlanine Transaminaseen
dc.subject.meshLiver Diseasesen
dc.titleA prospective study on the causes of notably raised alanine aminotransferase (ALT).en
dc.typeArticleen
dc.contributor.department1 ] Univ Iceland, Fac Med, Reykjavik, Iceland [ 2 ] Natl Univ Hosp Iceland, Fac Med, Div Gastroenterol & Hepatol, Dept Internal Med, Reykjavik, Iceland, Landspitali National University Hospital University of Icelanden
dc.identifier.journalScandinavian journal of gastroenterologyen
dc.rights.accessLandspitali Access - LSH-aðganguren
html.description.abstractHigh levels of alanine aminotransferase (ALT) can be a marker of severe liver disease with variable aetiologies and prognosis. Very few prospective studies have been undertaken on the aetiology and prognosis of patients with high ALT levels. No population-based prospective study has systematically evaluated drug-induced liver injury (DILI) among these patients. The objective was to determine the aetiology and prognosis of patients with high ALT.
html.description.abstractIn a catchment area of 160,000 inhabitants, a population-based prospective study identified all adult patients with serum level of ALT >500 U/L during a 12-month period. All underwent thorough diagnostic work-up and follow-up. In suspected DILI, causality was assessed with Roussel Uclaf Causality Assessment Method.
html.description.abstractA total of 155 patients were identified with ALT >500 U/L, 12 children and one with ALT of non-liver-related origin, leaving 142 patients for the analysis: 73 (51%) males, median age 52 (IQR 36-68, range 19-89 years). The most common causes were choledocholithiasis 48/142 (34%), ischaemic hepatitis 26 (18%), viral hepatitis 16 (11%) and DILI 15 (11%), hepatobiliary malignancy (n = 6), surgery/interventions (n = 8) and other aetiologies (n = 23). No specific aetiology was found in 6% of cases. In the total study cohort 99 (70%) required hospitalisation, 78 (55%) had jaundice and 22 (16%) died, liver-related death in 10%, 35% in IH and 7% in DILI.
html.description.abstractThe most common cause of notably high ALT was choledocholithiasis. Ischaemic hepatitis was a common aetiology with approximately 35% liver-related mortality. Viral hepatitis and DILI were important aetiologies among these patients.


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