Copyright ©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Mar 14, 2020; 26(10): 1020-1028
Published online Mar 14, 2020. doi: 10.3748/wjg.v26.i10.1020
Abnormal liver function tests associated with severe rhabdomyolysis
Andy KH Lim
Andy KH Lim, Department of General Medicine, Monash Health, Clayton VIC 3168, Australia
Andy KH Lim, Department of Medicine, School of Clinical Sciences, Monash University, Clayton VIC 3168, Australia
Author contributions: Lim AKH conceptualized and wrote the paper.
Conflict-of-interest statement: I have no potential conflict of interest to declare and have not received funding support for this work.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
Corresponding author: Andy KH Lim, MBBS, FRACP, MMed(ClinEpi), PhD, Senior Lecturer, Staff Physician, Department of General Medicine, Monash Health, and Department of Medicine, School of Clinical Sciences, Monash University, 246 Clayton Road, Clayton VIC 3168, Australia.
Received: October 28, 2019
Peer-review started: October 28, 2019
First decision: December 12, 2019
Revised: January 6, 2020
Accepted: March 9, 2020
Article in press: March 9, 2020
Published online: March 14, 2020
Core Tip

Core tip: There is observational and experimental data demonstrating that serum alanine and aspartate aminotransferases can be elevated in patients with rhabdomyolysis due to muscle release of these enzymes, and cause confusion with liver disease. Clinicians should firstly appreciate this association exists and secondly, understand the typical pattern and trajectory of the levels of creatine kinase and aminotransferases in the setting of rhabdomyolysis. An atypical trajectory, concurrently elevated bilirubin or γ-glutamyl transferase, or serum alanine aminotransferase levels above 800 U/L are inconsistent with isolated muscle injury as the cause of the elevated aminotransferases, and further investigation for liver disease may be warranted.