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lüll Liver enzyme alteration: a guide for clinicians Giannini EG; Testa R; Savarino VCMAJ 2005[Feb]; 172 (3): 367-79Isolated alterations of biochemical markers of liver damage in a seemingly healthy patient can present a challenge for the clinician. In this review we provide a guide to interpreting alterations to liver enzyme levels. The functional anatomy of the liver and pathophysiology of liver enzyme alteration are briefly reviewed. Using a schematic approach that classifies enzyme alterations as predominantly hepatocellular or predominantly cholestatic, we review abnormal enzymatic activity within the 2 subgroups, the most common causes of enzyme alteration and suggested initial investigations.|*Liver Function Tests[MESH]|Alanine Transaminase/*blood[MESH]|Alkaline Phosphatase/*blood[MESH]|Aspartate Aminotransferases/*blood[MESH]|Bilirubin/blood[MESH]|Female[MESH]|Humans[MESH]|Liver Diseases/*diagnosis/enzymology[MESH]|Liver/*enzymology[MESH]|Male[MESH]|Prothrombin Time[MESH]|Reference Values[MESH]|Serum Albumin/analysis[MESH]|gamma-Glutamyltransferase/blood[MESH] |