An elevation of the liver enzymes indicates damage or inflammation to the liver cells. When this happens, these enzymes leak out into the bloodstream, where they can be detected and measured with blood tests. The causes for elevation of the liver enzymes in children may include inflammation from viral infections, trauma, and congenital or genetic conditions.
Liver Enzymes
A blood test called the hepatic or liver panel can measure the levels of liver enzymes in the blood stream. The two most commonly measured liver enzymes include alanine transaminase, or ALT, and aspartate transaminase, or AST. ALT is more specific to liver damage than AST, since the latter can also be found in other tissues, such as the heart, the muscles, and the kidneys. Other enzymes tested in the liver panel include alkaline phosphatase, an enzyme that detects damage to the bile ducts, and bilirubin, the substance that, in the presence of liver damage, causes jaundice.
Causes
Any condition that causes damage or inflammation to the liver cells can cause elevation of the liver enzymes. Common conditions that cause elevated liver enzymes in children include viral illnesses, especially with the hepatitis viruses, the Epstein-Barr virus that causes mononucleosis, and other viruses such as the herpes, varicella and CMV viruses. Other causes of elevated liver enzymes in children include autoimmune hepatitis, in which the body's immune system attacks its own liver tissue thinking it is foreign; and congenital or hereditary conditions such as hemochromatosis, which causes abnormal accumulation of iron within the liver.
Symptoms of Acute Poisoning
The symptoms that accompany the elevation of liver enzymes in children vary with the condition. In general the symptoms of liver damage include jaundice, or a yellowish pigmentation of the skin and the eyes as a result of elevation of bilirubin; hepatomegaly, or enlargement of the liver; dark urine; and light stools. Other symptoms include nausea, vomiting, weight loss and abdominal pain. Children may appear lethargic and have other changes in mental status, such as confusion.
Treatment
The treatment depends on the original cause of the elevation of the liver enzymes. Options include supportive treatment with intravenous fluids and pain medicines; antiviral medications in some cases of viral hepatitis; and avoiding medicines like acetaminophen that can cause further liver injury. Liver transplantation may be required in severe cases of liver damage, and in children with certain genetic conditions.
