Elevated GGT Levels: Implications and Concerns - Gastroenterology and Hepatology

Re-evaluating abnormal aminoacyl transferase levels?

I apologize for asking you again about the abnormality of gamma-glutamyl transferase (GGT).
Recently, during a health check at my company, my GGT level was found to be abnormal at 104.
However, the alkaline phosphatase (ALP) level was 165, which is within the normal range, and my SGOT (AST) was 23, GPT (ALT) was 18, AFP was 3.15, HDL cholesterol was 53.7, and LDL cholesterol was 115, all of which are normal values.
My abnormal values were total cholesterol at 207 and triglycerides at 190.
My pulse was 100, while the rest were normal.
I usually monitor my blood pressure, which is normal in summer at 120-130/70-80, but sometimes in winter it exceeds 140/90.
I went to another hospital for a follow-up, had my blood drawn again, and underwent an abdominal ultrasound, which confirmed that I do not have hepatitis B or C.
However, my GGT level remains abnormal at 104.
The abdominal ultrasound revealed a 0.6 cm tumor in the liver, which the doctor said is a hemangioma and advised me not to worry, but to return for follow-up in six months.

My questions are: Could the abnormal GGT be caused by the liver hemangioma? Since I have never had my GGT tested before, if it remains elevated, could it lead to any adverse pathological changes? Is there a possibility that the hemangioma could be misdiagnosed or transform into a malignant tumor? Is a six-month follow-up too long? Thank you again, Dr.
Lin.

yyc, 40~49 year old female. Ask Date: 2008/09/27

Dr. Lin Minghui reply Gastroenterology and Hepatology

Hello,
1.
The hepatic hemangioma is 0.6 cm in size, which is small, but it requires monitoring.
The ultrasound shows typical characteristics of the hemangioma.
Due to the small size of the tumor, ultrasound is a better tool for follow-up.
Generally, clinical guidelines recommend monitoring every 4 to 6 months.
2.
There may be benign or malignant tumors within the liver, which can sometimes cause abnormal liver function tests.
Elevated GGT is less specific, as it can be associated with liver, gallbladder, kidney, and pancreatic diseases.
Your other liver function tests are normal, so it is advisable to continue monitoring and to check for any issues with other organs.
Wishing you good health,
Dr.
Lin Ming-Hui, Taoyuan Hospital, Department of Health

Reply Date: 2008/09/27

More Info

Elevated levels of Gamma-Glutamyl Transferase (GGT) can be a significant indicator of various health issues, particularly related to liver function and bile duct health. GGT is an enzyme found in many tissues throughout the body, but it is particularly concentrated in the liver. When GGT levels are elevated, it often suggests that there may be some form of liver dysfunction, bile duct obstruction, or other underlying health conditions.

In your case, a GGT level of 104 is indeed elevated, especially when considering that normal ranges typically fall between 12-64 U/L for males. Elevated GGT can be associated with several factors, including alcohol consumption, liver disease, bile duct obstruction, and even certain medications. However, it is important to note that GGT is not specific to liver disease alone; it can also be elevated in conditions affecting the pancreas, kidneys, and even in cases of heart disease.

You mentioned that your alkaline phosphatase (ALKP) levels were normal, which is a good sign, as elevated ALKP alongside GGT often points more directly to bile duct issues. The normal levels of SGOT (AST) and SGPT (ALT) further suggest that there may not be significant liver cell injury at this time. However, the elevated GGT still warrants attention.

Regarding your concern about the hepatic hemangioma (blood vessel tumor) that was found during your ultrasound, it is generally considered a benign condition. Hepatic hemangiomas are the most common benign tumors of the liver and are usually asymptomatic. They rarely cause complications and are typically monitored rather than treated unless they cause symptoms or complications. The presence of a hemangioma is unlikely to be the direct cause of elevated GGT levels. However, it is essential to continue monitoring it, as advised by your physician.

As for the frequency of follow-up examinations, a six-month interval is a standard recommendation for monitoring benign liver lesions like hemangiomas. This timeframe allows for adequate observation of any changes in size or characteristics of the lesion. If there are any changes in your symptoms or if you experience new symptoms, you should consult your healthcare provider sooner.

In terms of potential health implications of persistently elevated GGT levels, while it is not uncommon for GGT to fluctuate, consistently high levels could indicate ongoing liver stress or damage. It is crucial to maintain a healthy lifestyle, including a balanced diet, regular exercise, and avoiding alcohol, as these factors can significantly impact liver health.

If you have concerns about the potential for your hemangioma to transform into a malignant tumor, it is important to discuss these with your healthcare provider. While the risk is extremely low, your doctor can provide reassurance and additional information based on your specific health history and the characteristics of the hemangioma.

In summary, while elevated GGT levels warrant further investigation, the benign nature of your hepatic hemangioma and the normal results of other liver function tests are reassuring. Continue to follow your doctor's recommendations for monitoring and maintain a healthy lifestyle to support your liver health. If you experience any new symptoms or have further concerns, do not hesitate to reach out to your healthcare provider for guidance.

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