Differential diagnosis of increased transaminases serum levels

Elevated serum levels of transaminases must always be considered as an abno rmal finding. Drugs and toxins must be eliminated first as possible hepatot oxic agents or co-factors. Antiviral hepatitis A IgM determination is the f irst test to perform. However, other Viruses with spontaneous benign course s are the most frequent cause. Only if the initial presentation is severe, or if liver tests remain abnormal after several weeks, can other rare disea ses be sought, Liver biopsy is rarely necessary to reach a diagnosis. (C) 2 001 Editions scientifiques et medicales Elsevier SAS.