suggested protocol for investigation of a raised GGT in an asymptomatic patient without risk factors for or clinical features of liver disease

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Recommended investigation for isolated raised abnormal gamma glutamyl transpeptidase(GGT) in an asymptomatic patient without risk factors for or clinical features of liver disease in primary care (1):

  • GGT has limited utility as a primary liver test
  • the measurement of GGT is recommended in particular to establish the likely origin of a raised Alk Phos
  • there is no clear consensus on thresholds for further investigation (1)
    • suggested that if a mildly raised GGT (<3 upper limit of normal (ULN)) then this is a justification for interval retesting
    • if GGT rises >5 ULN justify consideration of ultrasound if cause is not apparent

Notes:

  • in the absence of clear guidance it is recommended that if results >2 ULN (unexplained by laboratory tests)
    • referral to secondary care is indicated (1)

Reference:

  1. Clinical Knowledge Summaries (accessed 6/4/07). How should I investigate an isolated 'slightly raised' gamma glutamyl transpeptidase in an asymptomatic adult? www.cks.library.nhs.uk

Last reviewed 03/2020