Abnormal liver enzyme levels. Clinical evaluation in asymptomatic patients.

Chronic elevation of liver enzyme levels requires attention, because it may indicate serious liver disease. The pattern of elevation, whether hepatocellular or cholestatic, is used to guide the evaluation. The goal is to diagnose treatable forms of liver disease. Occasionally, a diagnosis cannot be established with noninvasive screening tests, and regular follow-up is then recommended. The role of liver biopsy in such cases is controversial.