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A 23-year-old male asked:

Liver alt elevated -mrcp and fibroscan nrml.no hep,drugs,alcohol,not fat, wilsons autoimmune etc what could it be? ~2xuln all common things checked.

3 doctor answers3 doctors weighed in
Dr. Kristel Hunt
Hepatology 23 years experience
AST is normal?: so ALT elevation is the only abnormality? with all negative workup to date? NASH still most likely, even if you're not overweight. if your waist-to-hip ratio is more than 0.8, would consider trying to lose 5-10lbs and see if normalizes. if not, a biopsy may be in order.
Dr. Kristel Hunt
Hepatology 23 years experience
Provided original answer
Dear 'scared of biopsy', totally understand. your AST is not normal either - both should really be in teens, low 20s. the lab range as Dr Roschmann discussed above already contains a whole lot of abnormal values - so 40 itself is ~2xULN. My hunch is a bit of fatty inflammation. let us know how it goes.
Aug 16, 2014
Dr. Robert Roschmann
Rheumatology 46 years experience
May represent ....: A statistical anomaly. ~ 1 out of every 20 lab tests may be above/below the famous "Bell Curve" that describes statistical variability. In addition, your ALT represents a very slight elevation of only 1 test. Typically in significant liver issues you will see a pattern of several enzyme tests often elevated 3x (or more) above normal. The ALT is a momentary "snapshot" that could be WNL with recheck
Dr. Laura Martin
Family Medicine 32 years experience
?normal: many people just dont fall in the normal range of tests, you have ha a lot of tests, might just be you. I would likely just start to follow it over time and not react unless progressive change

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Last updated Aug 16, 2014

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