Elevated liver enzyme is a common incidental laboratory finding. Evaluating such problems particularly in asymptomatic patients might be challenging. Alterations in liver enzymes are not enterily specific to liver disease. Aspartate aminotransferase (AST), alanine transaminase (ALT), and lactate dehydrogenase (LDH) can also rise in muscle disorders [1–3]. In some series, up to 80% the patients with myopathy had increased aminotransferase levels [4]. Physicians’ lack of awareness regarding AST/ALT elevation as an indicator of muscle damage might lead to misdiagnosis of primary liver disease, unnecessary hepatic evaluation and increased liver work-up cost in addition to delay in diagnosis of muscle disorders [2,4].
