Hypertransaminasemia in patients with negative viral markers.

The inclusion of aminotransferase and alkaline phosphatase (AP) determination within routine laboratory tests for patients in both primary care and hospital care has brought about an increase in the detection of symptomatic-stage liver disturbances. Viral hepatitis is the most common cause of aminotransferase elevation, and accounts for more than 90% of acute hepatitis. Diagnosis is easily confirmed through serologic immune marker determination and even genetic techniques. However, a small percentage of viral hepatitis remain undetected by these methods. On the other hand, other causes that may induce transaminase elevation include alcohol, and metabolic, toxic, autoimmune, infectious, cholostatic or endocrine disturbances, many of which may respond to either specific or symptomatic treatment.