The transaminase level in the pre-employment physical examination is high

Formal employers will conduct an entry physical examination before employees start working, and the examination covers some very basic items. Some people are found to have high transaminase levels during physical examinations. There are many reasons for high transaminase levels. If you have had a cold, fever, or overwork recently, your transaminase levels will increase. However, high transaminase levels also mean that hepatitis B virus may be present in the body. Let’s learn about the specific situation in this article.

What to do if transaminase is elevated?

There are many reasons for elevated transaminase levels. The most common causes are hepatitis B virus, fever, and fatigue. It can also be caused by infection with other pathogens or other diseases. Generally, as the symptoms or disease disappear, transaminases return to normal. If the transaminase is abnormal, the hepatitis B virus (HBV) serum markers (several of the five items including HBsAg) are positive, and there are obvious clinical symptoms such as fatigue, poor appetite, aversion to oil, nausea, yellow urine, etc., then the patient can be diagnosed as a typical hepatitis B patient and should be hospitalized as soon as possible to prevent it from turning into chronic hepatitis and infecting others.

What is controversial and difficult to deal with is that a single aminotransferase is high (one or several times the normal value), the hepatitis B virus serum marker is positive, but there is no clinical symptoms. Some have also undergone regular treatment, but the aminotransferase is still high without any symptoms, and the hepatitis B virus serum marker has not changed. Should this situation be regarded as a hepatitis B patient or a hepatitis B virus carrier? From the perspective of molecular biology, an increase in a single aminotransferase can only indicate that the permeability of the liver cell plasma membrane to the enzyme has changed, and it cannot be used as direct evidence of liver cell inflammation and necrosis.

According to modern infectious disease viewpoints, it is more reasonable to regard it as a latent infection state. Therefore, there may be no essential difference between this type of asymptomatic person with elevated single aminotransferase level and a hepatitis B virus carrier. Whether it is fair to treat all candidates in this situation as hepatitis B patients and refuse admission to school is worthy of discussion and research.

For patients with elevated single aminotransferase levels, we use proven enzyme-lowering drugs, such as Schisandra chinensis and Panax notoginseng, to restore the aminotransferase to normal in a relatively short period of time. We can also carry out consolidation treatment without interrupting their studies, and with close observation and regular follow-up, the vast majority of patients can achieve ideal outcomes. In some patients, transaminase levels rise to several or even dozens of times the normal value during the treatment process, but the patient remains asymptomatic. This is often a sign that the body's immune cells' phagocytic function has recovered and the liver cells invaded by the virus have been cleared. After the increase, the level will return to normal and should be regarded as a sign of response to treatment.

What does a mild increase in transaminase mean?

Alanine aminotransferase is very sensitive. A slight increase in transaminase indicates liver damage, but generally speaking, if it does not exceed 80 and aspartate aminotransferase is also normal, it is very likely transient and may be caused by fatigue, drinking, fever or taking cold medicine. He was also told to check his liver function again in half a month and to seek medical attention anytime if he felt unwell.

Why is alanine aminotransferase so sensitive?

Experts explain that alanine aminotransferase is mainly found in the liver, heart and skeletal muscles. When liver cells or certain tissues are damaged or necrotic, the alanine aminotransferase in the blood will increase. There are many diseases that can cause abnormal transaminase, which must be identified:

1. Viral hepatitis: the most common disease that causes elevated transaminase levels. All types of acute and chronic viral hepatitis can lead to elevated transaminase levels.

2. Toxic hepatitis: A variety of drugs and chemical agents can cause elevated transaminases, but after stopping the drug, transaminases can return to normal;

3. Heavy or long-term drinkers: Alanine aminotransferase will also increase;

4. Acute attacks of cholecystitis and cholelithiasis caused by biliary diseases: fever, abdominal pain, nausea, vomiting, jaundice, elevated blood bilirubin and transaminase are common. After inflammation is controlled and transaminase drops to normal, B-ultrasound or X-ray examination can be performed;

5. In acute heart diseases such as myocardial infarction, myocarditis, and heart failure: both alanine aminotransferase and aspartate aminotransferase are elevated, and patients often have chest pain, palpitations, shortness of breath, and edema. Cardiac examination showed positive signs and abnormal electrocardiogram;

6. Certain other infectious diseases: such as pneumonia, typhoid fever, tuberculosis, infectious mononucleosis, etc., all have the phenomenon of elevated transaminase, but these diseases each have typical clinical manifestations and can be diagnosed with the help of laboratory tests.

In addition, transient elevations of transaminases may also occur in acute soft tissue injuries, strenuous exercise, and pregnancy.

Therefore, when elevated transaminase levels are found during a physical examination, do not worry too much or take medication blindly. Instead, recheck your liver function after a good rest.

Does abnormal alanine aminotransferase mean hepatitis?

Alanine aminotransferase was formerly called alanine aminotransferase, abbreviated as GPT in English. Now it is uniformly called alanine aminotransferase, abbreviated as ALT in English. Therefore, ALT is transaminase written by doctors on the test report. Many children are found to have abnormal ALT when they enter kindergarten, enlist in the army, join a company, or have a physical examination for school, and they are mistakenly believed to have hepatitis. In fact, this is not always the case. They should go to a specialized hospital for a systematic examination to find out the cause and receive treatment.

There is abundant transaminase in liver cells. When liver cells are damaged due to various reasons and become inflamed or necrotic, transaminase is released into the blood, causing the transaminase level in the blood to rise rapidly. However, transaminase is not only present in liver cells, but also widely present in myocardial, kidney, muscle and other cells. Therefore, when there are diseases of the heart, kidney, muscle, and skin, the transaminase level in the blood may also increase, but not as significantly as in liver disease. Therefore, when diagnosing hepatitis, a comprehensive analysis should be conducted to exclude diseases of other organ systems in the body. Then, combined with the patient's clinical manifestations and epidemiological history, a comprehensive analysis can be made to obtain a correct diagnosis. It is not comprehensive to assume that it is hepatitis when the transaminase level is elevated. It may sometimes lead to misdiagnosis and cause unnecessary trouble.