Liver disease in adolescents

Adolescents with liver disease are often asymptomatic, or they may have mild, non-specific symptoms. In fact, abnormal laboratory tests frequently are the only indication of liver dysfunction. According to a large population-based study, up to 9% of asymptomatic individuals may have elevated liver aminotransferases (alanine aminotransferase [ALT], aspartate aminotransferase [AST]).¹ Failure to evaluate persistently elevated liver enzymes may mean missing the opportunity for early diagnosis of a potentially treatable disease. Conversely, an extensive evaluation of all abnormal test results may expose many adolescents to unnecessary risks and expense. With understanding of the patterns of biochemical markers of liver injury, one may narrow the extensive list of differential diagnoses for an adolescent patient with persistent laboratory abnormalities.