Elevated liver enzymes, specifically alanine aminotransferase (ALT), over 1000 IU/l are primarily caused by three main conditions according to standard medical education.
Common Causes of Significantly Elevated Liver Enzymes
Here's a breakdown of the primary causes:
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Acute Ischaemia: This refers to a sudden reduction in blood flow to the liver, depriving it of oxygen and nutrients. This can lead to damage and the release of liver enzymes into the bloodstream.
- Example: A severe drop in blood pressure or a blood clot in a major vessel supplying the liver.
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Acute Drug-Induced Liver Injury (DILI): Certain medications or toxins can cause severe liver damage, leading to a drastic increase in liver enzymes.
- Example: Overdosing on paracetamol (acetaminophen) is a common cause.
- Note: DILI can be caused by prescription drugs, over-the-counter medications, and herbal supplements.
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Acute Viral Hepatitis: Infections from hepatitis viruses (like hepatitis A, B, or C) can cause inflammation and damage to liver cells.
- Example: Hepatitis A infection, which is often contracted through contaminated food or water.
- Note: Not all cases of viral hepatitis will result in such elevated enzyme levels.
Summary
| Cause | Description | Example |
|---|---|---|
| Acute Ischaemia | Sudden reduction in blood flow to the liver. | Severe drop in blood pressure, blood clot in liver vessel. |
| Acute Drug-Induced DILI | Liver damage caused by medications or toxins. | Paracetamol overdose. |
| Acute Viral Hepatitis | Liver damage from viral infections (e.g., Hepatitis A, B, or C). | Hepatitis A infection. |
The reference specifically mentions these three as the most common causes when ALT levels reach 1000 IU/l. Therefore, while other liver conditions can cause enzyme elevation, these are the most typical culprits when the levels are dramatically high.
