Strenuous Exercise-Induced Tremendously Elevated Transaminases Levels in a Healthy Adult: A Diagnostic Dilemma

The liver function test (LFT) is a commonly performed test in clinical practice in order to assess well-being of the liver; however, derangement in liver enzymes, however, may not necessarily imply an underlying liver pathology. The standard liver function test measures alanine aminotransferase (ALT...

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Main Authors: Prabin Khatri, Aryan Neupane, Suman Raj Sapkota, Bibhav Bashyal, Dipesh Sharma, Ashmita Chhetri, K. C. Chirag, Ashish Banjade, Priyanka Sapkota, Subarna. Bhandari
Format: Article
Language:English
Published: Wiley 2021-01-01
Series:Case Reports in Hepatology
Online Access:http://dx.doi.org/10.1155/2021/6653266
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author Prabin Khatri
Aryan Neupane
Suman Raj Sapkota
Bibhav Bashyal
Dipesh Sharma
Ashmita Chhetri
K. C. Chirag
Ashish Banjade
Priyanka Sapkota
Subarna. Bhandari
author_facet Prabin Khatri
Aryan Neupane
Suman Raj Sapkota
Bibhav Bashyal
Dipesh Sharma
Ashmita Chhetri
K. C. Chirag
Ashish Banjade
Priyanka Sapkota
Subarna. Bhandari
author_sort Prabin Khatri
collection DOAJ
description The liver function test (LFT) is a commonly performed test in clinical practice in order to assess well-being of the liver; however, derangement in liver enzymes, however, may not necessarily imply an underlying liver pathology. The standard liver function test measures alanine aminotransferase (ALT), aspartate aminotransferase (AST), alanine phosphatase (ALP), bilirubin levels (total, direct, and indirect), proteins (total protein and albumin), and PT-INR (prothrombin time and international normalized ratio). In addition to common causes, liver enzyme levels can also be elevated due to extrahepatic causes, such as muscular injury can elevate transaminases levels. Here in, we present a case of an asymptomatic healthy male who was doing vigorous exercise and presented with reports of elevated transaminase levels. During evaluation of the case, most of his reports came to be within normal range. Additionally, when reevaluated after discontinuation of vigorous exercise, 3 weeks later and then a month later, his liver enzyme levels were observed to be within normal range. Hence, we suspect that muscle damage-induced transaminitis might not have been considered in the differential diagnosis during the evaluation of a patient with raised transaminases levels and also suggest that it should be kept as a differential in the given scenario.
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spelling doaj-art-022ee112f18f4392b658914cc4a2a0862025-02-03T06:43:34ZengWileyCase Reports in Hepatology2090-65872090-65952021-01-01202110.1155/2021/66532666653266Strenuous Exercise-Induced Tremendously Elevated Transaminases Levels in a Healthy Adult: A Diagnostic DilemmaPrabin Khatri0Aryan Neupane1Suman Raj Sapkota2Bibhav Bashyal3Dipesh Sharma4Ashmita Chhetri5K. C. Chirag6Ashish Banjade7Priyanka Sapkota8Subarna. Bhandari9Universal College of Medical Sciences & Teaching Hospital, Bhairahawa, NepalUniversal College of Medical Sciences & Teaching Hospital, Bhairahawa, NepalUniversal College of Medical Sciences & Teaching Hospital, Bhairahawa, NepalUniversal College of Medical Sciences & Teaching Hospital, Bhairahawa, NepalUniversal College of Medical Sciences & Teaching Hospital, Bhairahawa, NepalUniversal College of Medical Sciences & Teaching Hospital, Bhairahawa, NepalUniversal College of Medical Sciences & Teaching Hospital, Bhairahawa, NepalUniversal College of Medical Sciences & Teaching Hospital, Bhairahawa, NepalUniversal College of Medical Sciences & Teaching Hospital, Bhairahawa, NepalUniversal College of Medical Sciences & Teaching Hospital, Bhairahawa, NepalThe liver function test (LFT) is a commonly performed test in clinical practice in order to assess well-being of the liver; however, derangement in liver enzymes, however, may not necessarily imply an underlying liver pathology. The standard liver function test measures alanine aminotransferase (ALT), aspartate aminotransferase (AST), alanine phosphatase (ALP), bilirubin levels (total, direct, and indirect), proteins (total protein and albumin), and PT-INR (prothrombin time and international normalized ratio). In addition to common causes, liver enzyme levels can also be elevated due to extrahepatic causes, such as muscular injury can elevate transaminases levels. Here in, we present a case of an asymptomatic healthy male who was doing vigorous exercise and presented with reports of elevated transaminase levels. During evaluation of the case, most of his reports came to be within normal range. Additionally, when reevaluated after discontinuation of vigorous exercise, 3 weeks later and then a month later, his liver enzyme levels were observed to be within normal range. Hence, we suspect that muscle damage-induced transaminitis might not have been considered in the differential diagnosis during the evaluation of a patient with raised transaminases levels and also suggest that it should be kept as a differential in the given scenario.http://dx.doi.org/10.1155/2021/6653266
spellingShingle Prabin Khatri
Aryan Neupane
Suman Raj Sapkota
Bibhav Bashyal
Dipesh Sharma
Ashmita Chhetri
K. C. Chirag
Ashish Banjade
Priyanka Sapkota
Subarna. Bhandari
Strenuous Exercise-Induced Tremendously Elevated Transaminases Levels in a Healthy Adult: A Diagnostic Dilemma
Case Reports in Hepatology
title Strenuous Exercise-Induced Tremendously Elevated Transaminases Levels in a Healthy Adult: A Diagnostic Dilemma
title_full Strenuous Exercise-Induced Tremendously Elevated Transaminases Levels in a Healthy Adult: A Diagnostic Dilemma
title_fullStr Strenuous Exercise-Induced Tremendously Elevated Transaminases Levels in a Healthy Adult: A Diagnostic Dilemma
title_full_unstemmed Strenuous Exercise-Induced Tremendously Elevated Transaminases Levels in a Healthy Adult: A Diagnostic Dilemma
title_short Strenuous Exercise-Induced Tremendously Elevated Transaminases Levels in a Healthy Adult: A Diagnostic Dilemma
title_sort strenuous exercise induced tremendously elevated transaminases levels in a healthy adult a diagnostic dilemma
url http://dx.doi.org/10.1155/2021/6653266
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