Retrospective evaluation of cases with high transaminases

In this study, we aimed to investigate the demographic characteristics and diagnoses of children with elevated transaminase levels who applied to the Pediatric Gastroenterology Hepatology and Nutrition Outpatient Clinic of our hospital between 2012 and 2022. A total of 797 patients, 340 (42,7%) female and 457 (57,3%) male, were included in the study. 24,6% of the patients were in the 0-1 age range, 37.8% were in the 1-5 age range, 16.9% were in the 6-10 age range, and 20.7% were in the 11-17 age range. When the AST values of the cases were examined, it was seen that 77,9% were mild, 11% were moderate and 11% were severely high. Considering the ALT values at the time of admission, 0,4% were found to be normal, 71,4% mild, 14.4% moderate and 13.3% severe. The rate of severe AST elevation in girls (15,2%) was significantly higher than in boys (7.9%) There was no significant difference between the genders in terms of ALT elevation (p=0.549). When the patients were grouped according to their diagnoses, 375 (47%) were due to infectious (viral hepatitis, non-hepatotropic viruses and non-viral hepatitis infections viruses). Thirty- one (24,6%) of the cases with viral hepatitis were HAV infection. There were 89(10.5%) patients with drug-induced transaminase elevation. The other diagnosis groups were Steatohepatitis 23 (2.9%), multi-trauma patients (0.4%), myositis (0.1%), and cholestasis due to total parenteral nutrition (TPN) (2.8%), respectively. As a result, in our study, when the patients were grouped according to their diagnoses, we found that most of them were infectious (viral hepatitis, non-hepatotropic viruses). Therefore, we suggest that infectious markers should betaken into account in the etiological evaluation of children with elevated transaminase levels. Although they are less common, we recommend investigating diseases such as genetic/metabolic diseases, autoimmune hepatitis, and celiac disease, in which the progression of the disease can be prevented with early diagnosis and treatment. In most of the cases, elevated transaminases were detected during investigation due to complaints not specific to liver disease. We emphasize that transaminase elevation should also be checked when investigating another non-liver-specific complaint. In our study, we would like to emphasize that further diagnostic tests should be planned according to the course of transaminases, since in some of the children for whom the etiologic cause could not be determined, transaminases were self-normalized and the elevation continued for more than 6 months in others. Key words: Hypertransaminasemia, etiology, children