How do you identify the cause of transaminase elevation in patients with chronic hepatitis?
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The most common identifiable causes of chronic hepatitis are alcohol abuse, viral hepatitis, and hemochromatosis; therefore, the initial evaluation of chronic transaminase elevation should include a targeted history, physical examination, and laboratory evaluation for these etiologies. (SOR C, based on cross-sectional studies and expert opinion.) If the initial investigation is negative, further evaluation for nonalcoholic steatohepatitis, autoimmune hepatitis, drug hepatoxicity, celiac disease, Wilson's disease, and alpha-1 antitrypsin deficiency should be performed. (SOR C, based on expert opinion.)
Evidence Based Practice 12(8): 12-13.