Undetectable Alanine Aminotransferase during Hospitalization

A 58-year-old man with chronic systolic heart failure and type 2 diabetes mellitus presented with bacteremia, acute exacerbation of chronic heart failure, and acute renal failure. He described poor appetite and drinking beer for several days. Alanine aminotransferase (ALT)2 was 16 U/L initially but decreased until it became undetectable (<6 U/L) on the Architect 16200 (Table 1). ALT was …