One possibility is alpha-1-anti-trypsin deficiency. This is a relatively
common inborn error but gives rise to clinical symptoms only late in life
(by which time liver transplant may be the only cure) and only in a
relatively small proportion of those with the defective gene.
Protein electrophoresis will of course point out those who may have the
deficiency.
But as one of our cardiologists said to me: "Why tell someone that they
have a potential for a disease that may possibly damage their lungs and/or
liver; and that they should desist from smoking and alcohol for the rest of
their life. What else is there to live for?" Cardiologists are known to
have limited horizons.
-----Original Message-----
From: This list is an open discussion list for the academic community
working in [mailto:[log in to unmask]]On Behalf Of Mike
Hallworth
Sent: Thursday, January 18, 2001 4:52 PM
To: [log in to unmask]
Subject: Mildly raised ALTs
What do other people advise when asked about persistent, mild (<2xULN)
isolated increases in ALT in otherwise (apparently) healthy people?. Every
couple of months I get a query about this from some GP or other who has
found it (usually by accident - as this morning's questioner said: "I wish
I'd never done it now"....).
Referral for liver Bx seems OTT (but is it?), attempts to pin the blame on
drink are usually resisted (and GGT/MCV usually OK). I tend to fall back on
the time-honoured 'keep an eye on it and if it's not rising I wouldn't
worry too much...'. Has ultrasound much to offer? Any further ideas?
Thanks
Mike
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