Liver Biopsy for Which Patients with Subclinical Elevated Transaminases

About 2.8% of the U.S. population has elevated serum alanine aminotransferase (ALT) levels. Although 90% of these cases are discovered from routine testing in the absence of symptoms, many such patients have underlying chronic liver disease. An increasing percentage of patients whose routine exams detect unsuspected elevated ALT levels have nonalcoholic steatohepatitis (NASH), which currently can be diagnosed only by liver biopsy. Given the expense and morbidity associated with …