Principles of management of patient with asymptomatic elevation of serum aminotransferases
Abstract
The aim of publication. Absence of clear practical guidelines on management of patients with asymptomatic elevation of serum aminotransferases can cause difficulties for general practitioners. Presented clinical case illustrates management approach in such cases.
The basic contents. Patient D. has admitted to the clinic in July, 2010 for changes blood biochemistry at absence of any symptoms or clinical signs. According to past history it was known: the patient is non-smoker, absolutely denies use of pharmaceuticals and alcohol abuse. At physical examination excessive body weight (BMI of 31 kg/m2) drew attention. The aim of investigation was definition of the cause of elevation of serum aminotransferases activity, and assessment of approach to further management. According to the data of carried out investigation the non-alcoholic steatohepatitis has been diagnosed, that was successfully treated by combination of metformin and ursodeoxycholic acid.
Conclusion. Estimating the submitted clinical case it is possible to conclude, that there is no strict association between accumulation of subcutaneous fat and severity of liver steatosis. Hence, non-alcoholic steatohepatitis always should be included in differential diagnostic range of search in patients with asymptomatic elevation of serum aminotransferases. For treatment of nonalcoholic steatohepatitis it is rational to use as drugs of choice metformin (treatment of insulin resistance) and ursodeoxycholic acid (anti-oxidative properties).
About the Authors
Ye. N. German
ГОУ ВПО«1-й Московский государственный медицинский университет им. И.М. Сеченова Росздрава»
Russian Federation
Russian Federation
M. V. Mayevskaya
ГОУ ВПО«1-й Московский государственный медицинский университет им. И.М. Сеченова Росздрава»
Russian Federation
Russian Federation
Ye. O. Lyusina
ГОУ ВПО«1-й Московский государственный медицинский университет им. И.М. Сеченова Росздрава»
Russian Federation
Russian Federation
V. T. Ivashkin
ГОУ ВПО«1-й Московский государственный медицинский университет им. И.М. Сеченова Росздрава»
Russian Federation
Russian Federation
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Review
For citations:
German Ye.N., Mayevskaya M.V., Lyusina Ye.O., Ivashkin V.T. Principles of management of patient with asymptomatic elevation of serum aminotransferases. Russian Journal of Gastroenterology, Hepatology, Coloproctology. 2011;21(1):63-68. (In Russ.)
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