TR Doktor
hepatit liver enzymes liver injury

Comparative analysis of patients hospitalized for severe transaminase elevation according to etiology and laboratory findings


Objective: The aim of this study is to investigate the etiological, epidemiological, clinical and laboratory findings of patients hospitalized in internal clinics with elevated transaminases and to create a point of view with clinical cues for acute hepatitis.

Methods: A total of 102 patients who were hospitalized in Internal Medicine and Infectious Diseases Clinics between January 2010 and September 2013 and whose transaminase levels were at least five times higher than the upper limit were included in the study. Patients’ age, sex, etiology, laboratory findings, length of stay in the clinic, and duration of liver enzymes normalizations were examined retrospectively. ANOVA, Kruskal-Wallis and chi-square tests were used in the analysis of qualitative and quantitative data.

Results: Of the 102 patients with acute liver injury, 58 (56.9%) were female and 44 (43.1%) were male. The average age is 46 years. The study group consisted of three main groups: toxic hepatitis (34.3%), acute viral hepatitis (25.5%) and ischemic hepatitis (17.6%). This was followed by acute nonbiliary pancreatitis (6.9%), autoimmune hepatitis (4.9%) and other (10.8%) groups. Transaminase and bilirubin values ​​were higher in acute viral hepatitis than other groups. Acute viral hepatitis group hospitalized for the longest time. The group which the liver enzymes recovered at the latest was toxic hepatitis. The two most common causes of toxic hepatitis were nonsteroidal anti-inflammatory drugs and herbal products. In the ischemic hepatitis group, the mean age was significantly higher. Alcohol use was not effective on the duration of hospitalization and normalization of liver enzymes.

Conclusion: Rapid determination of etiology, shortening hospitalization periot, and proper use of laboratory tests are important in patients with elevated transaminases. The purpose of this study is to enable the clinician to have an effective approach to acute liver damage.

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