Roadmap for evaluation of abnormal liver chemistries

Clinicians often struggle with the dilemma of how and when to approach a patient with unexplained elevated liver test results. Since this topic was last addressed in 2002, we lack data on the efficacy of evaluation of asymptomatic patients with minimally abnormal liver tests (1). Ever-changing and local lab driven dissimilar ranges for the upper limit of normal (ULN) liver tests contribute to the clinician resorting to use observation of the asymptomatic individual’s minimally elevated liver chemistries. Dr. Kwo and colleagues have addressed these gaps in this update of guidelines for the evaluation of abnormal liver chemistries (2). A close look at consultations for abnormal liver tests reveals several points of interest.