Elevated Liver Enzymes in Infants: What Parents Should Know

Liver function tests in infants?

Dear Doctor,
My daughter has just turned one year old.
Recently, we visited the pediatric endocrinology clinic due to concerns about her low weight.
After a blood test, the doctor indicated that her liver enzyme levels were elevated at 42.
During her vaccination appointment, the pediatrician also mentioned that the standard for liver enzyme levels in young children is generally below 35 or 40, and elevated levels are not very common.

I would like to ask:
1.
Given my daughter's situation, does she need further testing? Are there any other symptoms we should consider?
2.
What does "elevated liver enzymes" indicate regarding liver function? (I apologize if this sounds a bit amusing, but I truly do not understand.) What could be the possible causes?
Thank you for taking the time to respond.
Sincerely,
Mom Chen

Chen Mama, 30~39 year old female. Ask Date: 2006/12/28

Dr. Chen Jianhong reply Gastroenterology and Hepatology

Hello, Mrs.
Chen! A value slightly higher than the normal range may have pathological significance, and it may be necessary to consult a pediatric hepatologist for further evaluation.

Reply Date: 2006/12/28

More Info

Dear Chen Mama,
Thank you for your inquiry regarding your daughter's elevated liver enzymes. It's understandable to have concerns when it comes to your child's health, especially when it involves something as critical as liver function. Let’s delve into your questions.

1. Further Testing and Symptoms to Monitor: Given that your daughter’s liver enzyme levels (specifically, alanine aminotransferase, or ALT) are elevated at 42, which is above the typical reference range for infants (usually around 35 or 40), it is prudent to consider further evaluation. Elevated liver enzymes can indicate liver inflammation or damage, but they do not provide a definitive diagnosis on their own.
It would be advisable to consult with your pediatrician or a pediatric gastroenterologist for further testing. This may include additional blood tests to evaluate liver function more comprehensively, such as measuring aspartate aminotransferase (AST), alkaline phosphatase (ALP), bilirubin levels, and possibly conducting tests for viral hepatitis or metabolic liver diseases.
In terms of symptoms to monitor, look for signs such as jaundice (yellowing of the skin or eyes), dark urine, pale stools, fatigue, poor appetite, or abdominal swelling. If you notice any of these symptoms, it is essential to seek medical attention promptly.

2. Understanding Elevated Liver Enzymes: Elevated liver enzymes indicate that there is some form of stress or damage to the liver cells. The liver enzymes ALT and AST are released into the bloodstream when liver cells are injured. This can occur due to various reasons, including:
- Viral Infections: Hepatitis viruses (A, B, C, etc.) can cause liver inflammation.

- Metabolic Disorders: Conditions such as fatty liver disease, which can occur even in infants, or other metabolic disorders that affect how the liver processes fats and sugars.

- Toxins or Medications: Exposure to certain medications or toxins can lead to liver damage.

- Autoimmune Conditions: Rarely, autoimmune hepatitis can occur in children, where the body’s immune system attacks liver cells.

- Genetic Disorders: Conditions like Wilson’s disease or hemochromatosis can lead to liver dysfunction in children.

It is important to remember that elevated liver enzymes can be transient and may resolve on their own, especially if caused by a mild viral infection. However, persistent elevation warrants further investigation to rule out any serious underlying conditions.

In conclusion, while the elevated liver enzymes can be concerning, they are not uncommon in children and can often be managed effectively with appropriate medical guidance. I recommend following up with your healthcare provider for a thorough evaluation and to discuss any necessary next steps.
Wishing you and your daughter good health and peace of mind.

Best regards,
Doctor Q&A Teams

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