Liver enzymes are proteins within the liver cells. These enzymes help the liver in its role of detoxifying the body of harmful substances and toxins. A liver panel is a group of tests that detects and evaluates liver disease or damage by measuring enzymes produced or excreted by the liver and affected by liver injury. An elevation of liver enzymes indicates damage or inflammation of liver cells, also known as hepatitis. There are several causes of hepatitis in children.
Liver Enzymes
Although there are several liver enzymes, two of them in particular are measured on a routine basis to detect liver damage. These are aspartate aminotransferase, or AST, and alanine aminotransferase, or ALT. According to Lab Tests Online, ALT is the best test to detect hepatitis, or inflammation of the liver. Another enzyme, alkaline phosphatase, can be elevated if the bile ducts -- the tubes that transfer bile produces in the liver -- are blocked in children with liver disease.
Causes of elevated liver enzymes
Viruses are the most common causes of hepatitis in children. Viruses that cause hepatitis include hepatitis viruses A, B, and C, the Epstein-Bar virus, which causes infectious mononucleosis, the varicella, or chickenpox virus, and the cytomegalovirus, or CMV, virus. Other causes of hepatitis in children include poisoning or overdose with certain medications, such as acetaminophen; autoimmune hepatitis, in which the body mistakenly attacks the liver as foreign tissue causing liver inflammation; and chronic hepatitis, as can be caused by the hepatitis B and C viruses.
Symptoms
Children with liver disease and elevated liver enzymes can exhibit a wide range of symptoms. The initial symptoms can be nonspecific and include nausea and vomiting, body aches, and flu-like symptoms. Other symptoms more specific to liver damage include jaundice, or yellowing of the skin; dark colored urine; pain in the right upper part of the abdomen, where the liver is located; and easy bruising and bleeding.
Treatment
The treatment of elevated liver enzymes depends on the cause. Viral hepatitis may only require supportive treatment with intravenous fluids and fever control measures. Adequate nutrition is also important to maintaining appropriate growth and development. Immune modulators, which try to moderate the body's immune response, may be important in cases of autoimmune hepatitis. Frequent monitoring of liver enzymes levels is important to assess progression of disease. In severe cases, a child may require liver transplantation.
