Abnormal liver function tests associated with severe rhabdomyolysis

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.