Objective: To discover the frequency of presentation, the aetiological distribution and clinical importance of a moderate rise in transaminases, which were found by chance in patients free from hepatic symptomology who were attending primary care clinics.
Design: Descriptive study of a crossover type.
Setting: La Victoria Health Centre in Valladolid.
Patients: The patients attended at any of the six general medical clinics between january and june 1993, in whom a moderate rise in transaminases was detected by chance and confirmed after a one-month interval.
Measurements and main results: Hepatic function tests were performed on 1,285 patients, in 212 of whom biochemical function was found to be disturbed. 137 of these 212 were studied in line with a diagnostic procedure worked out in collaboration with the Area specialist, after 75 had been eliminated for various reasons. The following aetiological distribution was observed: Viral 37.2% (Anti VHC + 30.7%, Ag HBs + 6.5%), ethylic 35.03%, metabolic 15.32% and medicinal 8.77%. Hemochromatosis was diagnosed in 2 patients; and a possible aetiology could not be established in 3. It was possible to perform a biopsy on 11 patients, with the suspected aetiology being confirmed in all of them.
Conclusions: The likelihood of the primary care doctor correctly diagnosing hepatic illnesses is high, given that we could establish an aetiology in 97% of cases. The most common aetiologies were viral and ethylic.