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month download article/chapter alcoholic steatohepatitis references xv long-term follow chloe miu mak genetic liver diseases isolated persistent elevation article world journal full article pdf ching-wan lam privacy choices/manage cookies related subjects genetic liver disorders recent studies suggested yuet-ping yuen abnormal liver function higher prevalence rate long-term prognosis clinical sciences building long-term follow european economic area chi keung cheung classical teaching advised de ruyter korver article hui conditions privacy policy pre-symptomatic wilson princess margaret hospital queen mary hospital chung-mo chow journal finder publish accepting optional cookies case series illustrated long-term treatment isolated elevation main content log article log hepatic wilson disease oral zinc sulphate author correspondence check access instant access article cite disease access hong kong chinese tang department grace chiang & patrick joannie hui alanine transaminase pilot study genetic heterogeneity

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         headline:Isolated persistent elevation of alanine transaminase for early diagnosis of pre-symptomatic Wilson’s disease in Chinese children
         description:Recent studies presented a contradictory approach for the investigation of pediatric patients with an isolated increase in alanine transaminase. While classical teaching advised for a thorough investigation, recent studies suggested the yield on further investigation was low and thus not necessary. Yet the approach to the same clinical problem may need to be different due to variable disease prevalence rates among different ethnic populations. For the population with a higher prevalence rate of genetic liver diseases like Wilson’s disease, an abnormal liver function may be the first presenting feature for some patients. We reviewed 10 Chinese children with Wilson’s disease who were diagnosed at a presymptomatic stage because of an isolated persistent elevation of alanine transaminase. All 10 patients did not have overt symptoms of liver impairment or neurological deficit. They were picked up incidentally with an abnormal liver function test. All patients were started on treatment shortly after diagnosis, and they remained well and symptom-free on the latest follow-up. This case series illustrated that an isolated persistent elevation of alanine transaminase is an important clue to the early diagnosis of pre-symptomatic Wilson’s disease. It is particularly relevant in the Asian population where the disease is more prevalent.
         datePublished:2013-10-21T00:00:00Z
         dateModified:2013-10-21T00:00:00Z
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            Wilson’s disease
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      headline:Isolated persistent elevation of alanine transaminase for early diagnosis of pre-symptomatic Wilson’s disease in Chinese children
      description:Recent studies presented a contradictory approach for the investigation of pediatric patients with an isolated increase in alanine transaminase. While classical teaching advised for a thorough investigation, recent studies suggested the yield on further investigation was low and thus not necessary. Yet the approach to the same clinical problem may need to be different due to variable disease prevalence rates among different ethnic populations. For the population with a higher prevalence rate of genetic liver diseases like Wilson’s disease, an abnormal liver function may be the first presenting feature for some patients. We reviewed 10 Chinese children with Wilson’s disease who were diagnosed at a presymptomatic stage because of an isolated persistent elevation of alanine transaminase. All 10 patients did not have overt symptoms of liver impairment or neurological deficit. They were picked up incidentally with an abnormal liver function test. All patients were started on treatment shortly after diagnosis, and they remained well and symptom-free on the latest follow-up. This case series illustrated that an isolated persistent elevation of alanine transaminase is an important clue to the early diagnosis of pre-symptomatic Wilson’s disease. It is particularly relevant in the Asian population where the disease is more prevalent.
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         isolated persistent elevation
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         Imaging / Radiology
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                     type:PostalAddress
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