Main outcomes
We evaluated the proportion of patients with IM who had elevated LFTs in individual studies (Table 3). At presentation the following proportion of patients had elevated parameters: AST, 835/1472 (56.7%); ALT, 957/1546 (61.9%); ALP, 271/417 (65.0%); Bilirubin, 188/1160 (16.2%); GGT, 258/626 (41.2%). Six studies did not differentiate between the transaminases and reported 435/891 (48.8%) patients with raised values. Zhang et al. found reduce levels of total bilirubin in patients with IM compared to healthy control. Two studies included albumin within their testing and reported reduced albumin levels in 21/114 (18.4%) patients27,35.
Data on resolution of abnormal LFTs was largely incompletely reported (Table 3). Eleven studies reported following up patients with abnormal LFTs. Of these, eight studies reported maximum time to resolution of LFTs. The reported median (i.q.r.) time to complete resolution of all liver function parameters was 8 (6 – 12) weeks. One study found persistently raised LFTs in a small number of patients after 6 months of presentation 26.