Transaminases - AST and ALT

are particularly numerous:

• Hepatic causes:
• Alcohol;
  
• Cirrhosis;
  
• Chronic hepatitis B and C;
  
• Steatosis / steatohepatitis (accumulation of lipids in hepatocytes);
  
• Drugs / Toxics;
• Rarer causes:
  • Autoimmune hepatitis;
    
  • Hemochromatosis;
• Non-hepatic causes:
  • Celiac disease;
    
  • Hemolysis;
    
  • Myopathies;
    
  • Hyperthyroidism;
    
  • Intense physical exercise.

When faced with an increase in transaminases, it is necessary to immediately investigate:

• Risk factors such as drugs and alcohol consumption;
• Risk factors for contagion of viral hepatitis;

Without neglecting:

• The intake of herbal preparations (senna and Kava) and vitamins (vitamin A), often taken without a prescription
• A "careful dietary history of obesity, diabetes, dyslipideme.

Drugs that can alter transaminases are:

Heparin Acetylsalicylic acid Ticlopidine Phenytoin Barbiturates Carbamazepine Iron Nitrofurantoin Antifungals Nifedipine Amiodarone Verapamil Tetracycline Pennicillins Azithromycin Isoniazid Cotrimosazole Aminoglucosides Piroxicam Ranitidine Metronidazole Estrogen and progesterone Metoprolol