Liver Blood Enzymes
What Medications Cause Abnormal Aminotransferase Levels?
A host of medications can cause abnormal liver enzymes levels. Examples include:
- Pain relief medications such as aspirin, acetaminophen (Tylenol), ibuprofen (Advil, Motrin), neproxen (Narosyn), diclofenac (Voltaren), and phenybutazone (Butazolidine)
- Anti-seizure medications such as phenytoin (Dilantin), valproic acid, carbamazepine (Tegretol), and phenobarbital
- Antibiotics such as the tetracyclines, sulfonamides, isoniazid (INH), sulfamethoxazole, trimethoprim, nitrofurantoin, etc.
- Cholesterol lowering drugs such as the “statins” (Mevacor, Pravachol, Lipitor, etc.) and niacin
- Cardiovascular drugs such as amiodarone (Cordarone), hydralazine, quinidine, etc.
- Anti-depressant drugs of the tricyclic type
With drug-induced liver enzyme abnormalities, the enzymes usually normalize weeks to months after stopping the medications.
What Are Less Common Causes Of Abnormal Aminotransferase Levels?
Less common causes of abnormal liver enzymes in the United States include chronic hepatitis B, hemachromatosis, Wilson’s disease, alpha-1-antitrypsin deficiency, and autoimmune hepatitis. Though not as common as hepatitis C, hepatitis B can cause chronic liver disease with persistently abnormal liver enzymes.
Hemachromatosis is a genetic (inherited) disorder in which there is excessive absorption of dietary iron leading to accumulation of iron in the liver with resultant inflammation and scarring of the liver.
Wilson’s disease is an inherited disorder with excessive accumulation of copper in diverse tissues including the liver and the brain. Copper in liver can lead to chronic liver inflammation, while copper in brain can cause psychiatric and motor disturbances.
Alpha-1-antitrypsin deficiency is an inherited disorder in which the lack of a glycoprotein (carbohydrate-protein complex) called alpha-1-antitrypsin lead to chronic lung disease (emphysema) and to liver disease.
Autoimmune hepatitis results from liver injury brought about by the body’s own antibodies and defense systems attacking the liver.
Rarely, abnormal liver enzymes can be a sign of cancer in the liver. Cancer arising from liver cells is called hepatocellularcarcinoma or hepatoma. Cancers spreading to the liver from other organs (such as colon, pancreas, stomach, etc) are called metastatic malignancies.