What do liver values indicate?
April 16, 2012 | 15,00 EUR | answered by Dr. med. Hendrik Bernau
Dear Sir or Madam,
During a routine examination half a year ago, elevated liver values were detected in me: mainly GPT and GGT. Since September of last year until today, the values have been monitored at least monthly. Initially, the GPT and GGT values were between 150 and 200 (as of September 2011). They have now stabilized between 70 and 90, with occasional fluctuations up and down. GPT has also been elevated on its own at times. Despite extensive blood tests and a liver biopsy, a cause could not be found, except for a slight/minor liver cell steatosis.
My question now is: Can the values be elevated without any further cause? How can fluctuations occur? What do the transaminases specifically indicate: if there is an existing elevation, have fresh liver cells recently died? Or could a persistent, months-long elevation involve the same cells that were once destroyed and are now releasing transaminases?
What are the next steps you recommend in the diagnosis? The most common possible causes have already been checked (Hepatitis A, B, C, etc.). Is it very likely that a slight liver cell steatosis will develop into cirrhosis?
About me: male, 27 years old, 1.87 m, 78 kg.
Thank you and best regards.
Dear inquirer,
Your questions refer to the fluctuations in your GPT (Glutamate-Pyruvate Transaminase or Alanine Aminotransferase) and GGT (Gamma-Glutamyl Transferase) values. I am initially surprised by the information you have provided: Normal GPT values are around 50 U/l (units per liter), normal GGT values range between 12 and 64 U/l in adult males. Are you certain about your information?
Now, specifically to your questions:
1. Elevated GPT values can have the following causes:
- Liver inflammation (hepatitis) due to viruses and other causes
- Liver damage from toxins (e.g. fungi)
- Bile duct obstruction (cholestasis)
- Liver cirrhosis
- Congestive liver
- Fatty liver
- Liver tumors
- Metastases of malignant tumors in the liver
- Liver damage from medications
- Inflammation of the bile ducts (cholangitis)
Elevated GGT values can have the following causes:
- Hepatitis (liver inflammation)
- Fatty liver
- Liver cirrhosis
- Liver cancer or metastases of malignant tumors in the liver
- Benign tumors in the liver
- Gallbladder obstruction in the bile ducts (cholestasis)
- Inflammation of the bile ducts (cholangitis)
- Chronic pancreatitis
- Alcohol abuse
- Various medications
Please do not interpret from this list that you are suffering from any of the diseases listed here. I have provided this list for overview purposes: there can be various factors at play. These should be investigated separately. It is rather unlikely that the values you mentioned are increased "without further cause." In any case, you should consult your treating physician again.
2. Transaminases are typical indicators in liver diagnostics for damage to liver cells, with the extent of the increase correlating with the extent of the damage. In extensive liver cell necrosis, transaminases can rise to over 1000 U/l. If the values decrease, this could indicate improvement in the condition, but also the onset of liver failure.
Transaminase values provide timely information about the ongoing processes; the "same cells" you suspect would not justify a permanently elevated value.
3. Since your values, as you write, are under monthly medical observation and assessment, I recommend coordinating closely with your treating physician to potentially schedule further diagnostics. Another possibility could be a liver ultrasound. You mentioned that hepatitis was ruled out but a slight liver cell fatty infiltration was diagnosed.
4. Due to your regular check-up visits, I consider the risk of developing liver cirrhosis to be extremely low. The treating colleague will pay particular attention to this condition and act accordingly. A slight liver cell fat infiltration (perhaps inquire if a classification was made?) is not a reason to panic if monitored and treated accordingly.
I hope I have been able to assist you further. If you have any further questions, I am available at your convenience.
Wishing you good health.
Best regards,
Dr. med. - anonymized -
