Elevated GPT Levels: What You Need to Know - Gastroenterology and Hepatology

GOT is normal, while GPT is elevated?

Hello, doctor.
My brother underwent a military physical examination at your hospital last September, and the report indicated that his GOT levels were normal, but his GPT was elevated at 98.
He returned for a follow-up examination on February 29 of this year, and the report showed a GPT level of 96, which is still elevated.
During this period, he also had tests for alpha-fetoprotein and liver cancer at another hospital, both of which were normal.
He does not have hepatitis B or C.
Could you please advise if there is an issue with my brother's liver and what further tests you would recommend? Thank you.

peko, 20~29 year old female. Ask Date: 2012/03/03

Dr. Chen Shidian reply Gastroenterology and Hepatology

Hello, Ms.
Peko.

1.
If you have a higher body weight, fatty liver should be addressed by first losing weight and confirming with an ultrasound.

2.
Other potential causes such as medications and alcohol must also be ruled out.

Dr.
Chen Shidian from Changhua Hospital cares about your health.

Reply Date: 2012/03/03

More Info

Elevated levels of GPT (Glutamate Pyruvate Transaminase), also known as ALT (Alanine Aminotransferase), can be a cause for concern as they may indicate liver dysfunction or damage. In your brother's case, the consistently elevated GPT levels of 98 and 96, despite normal GOT (Glutamate Oxaloacetate Transaminase, or AST) levels, suggest that there may be some underlying issue with liver health, even though other tests, such as the alpha-fetoprotein (AFP) and liver cancer screenings, have returned normal.

GPT is primarily found in the liver, and its elevation typically signifies liver cell injury. The normal range for GPT levels can vary slightly depending on the laboratory, but generally, levels above 40 U/L are considered elevated. In your brother's case, his levels are significantly above this threshold, which warrants further investigation.

There are several potential causes for elevated GPT levels, including:
1. Fatty Liver Disease: Non-alcoholic fatty liver disease (NAFLD) is common and can lead to elevated liver enzymes. It is often associated with obesity, diabetes, and hyperlipidemia.

2. Alcohol Consumption: Even moderate alcohol intake can lead to elevated liver enzymes. If your brother consumes alcohol, it may be worth discussing his intake with a healthcare provider.

3. Medications: Certain medications can cause liver enzyme elevations. If your brother is taking any medications, it would be prudent to review them with a physician.

4. Viral Hepatitis: Although you mentioned that he does not have hepatitis B or C, other viral infections can also affect liver function.

5. Autoimmune Liver Disease: Conditions such as autoimmune hepatitis can lead to elevated liver enzymes and may require specific tests to diagnose.

6. Hemochromatosis or Wilson's Disease: These are genetic conditions that can lead to liver damage and elevated enzymes.

Given that your brother's GPT levels remain elevated, it is advisable to pursue further evaluation. Here are some recommended steps:
1. Comprehensive Metabolic Panel: This will provide additional information about liver function and other organ systems.

2. Ultrasound or Imaging Studies: An abdominal ultrasound can help assess the liver's structure and detect any abnormalities such as fatty liver or lesions.

3. Liver Biopsy: In certain cases, a liver biopsy may be necessary to determine the extent of liver damage or to diagnose specific liver diseases.

4. Additional Blood Tests: Tests for autoimmune markers, iron studies, and ceruloplasmin levels can help rule out other liver conditions.

5. Lifestyle Modifications: If your brother is overweight or has other risk factors, lifestyle changes such as diet and exercise can significantly impact liver health.

In conclusion, while the elevated GPT levels are concerning, they do not necessarily indicate severe liver disease, especially in the absence of other symptoms or abnormal findings. However, continued monitoring and further diagnostic testing are essential to determine the underlying cause and to ensure appropriate management. It is crucial to work closely with a healthcare provider to develop a tailored plan for your brother's health.

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