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Hoffmann, R. A wiki for the life sciences where authorship matters. Nature Genetics (2008)

Subclinical Addison's disease: a cause of persistent abnormalities in transaminase values.

A common reason for referring patients to hepatologists is persistently abnormal serum transaminase levels with vague constitutional symptoms. In the United Kingdom, these abnormalities are most often caused by a fatty liver either related to obesity or alcohol abuse; they are less commonly caused by chronic liver disease, particularly chronic viral hepatitis, autoimmune hepatitis, or chronic biliary disease. Endocrine disease is rarely a cause of these abnormalities, although hypothyroidism and hyperthyroidism are well-recognized causes. Addison's disease has been only reported once in the literature by R. G. Olsson as a cause of increased transaminase levels associated with constitutional symptoms; it is not mentioned in textbooks on hepatology. Three patients with Addison's disease are reported here, all of whom had increased serum transaminase levels for more than 6 months before the recognition of the hypoadrenalism with resolution to normal after steroid replacement. Hepatologists should consider subclinical Addison's disease as a cause of persistently increased transaminase levels with constitutional symptoms in the absence of evidence for fatty liver as well as viral and autoimmune markers.[1]


  1. Subclinical Addison's disease: a cause of persistent abnormalities in transaminase values. Boulton, R., Hamilton, M.I., Dhillon, A.P., Kinloch, J.D., Burroughs, A.K. Gastroenterology (1995) [Pubmed]
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