Prolonged Abnormal Isolated Aminotransferase Levels in Healthy Children is a Benign Condition

Aim: Hypertransaminasemia is common incidental finding in children. It has been demonstrated that even prolonged elevation usually resolves spontaneously without clear etiology. The aim of this study was to evaluate whether a longer follow up period, on a larger group, supports the previous findings.

Methods: We retrospectively reviewed medical charts of children diagnosed with prolonged idiopathic hypertransaminasemia, which spontaneously resolved over the follow-up period.

Results: Of the 468 patients screened for elevated transaminases levels, 87 patients younger than 5 years of age, were included in the study. An etiology was found in half of the patients, and the most common etiologies were fatty liver and Cytomegalovirus (CMV) infection.

Aminotransferases abnormality persisted for a median of 10 months, Alanine aminotransferase (ALT) levels ranged from 1.5 - 15.9 fold of the Upper Limit of Normal (ULN).

After normalization of transaminases levels, the values remained normal for a documented mean period of 6.4±3.0 years.

Conclusions: Although idiopathic asymptomatic aminotransferases elevation in healthy children resolves spontaneously in most children, the abnormality may be prolonged. Comprehensive workup finds etiology only in half of the patients, and the most common etiologies are fatty liver and CMV hepatitis, which can be diagnosed by non invasive methods.