Isolated Raised GGT

 

 

Key Features of Assessment

(In patients > 80 years oldor with significant frailty use clinical  to avoid unnecessary investigation)

 

In addition to usual assessment check for:

• Diabetes,
• Excessive alcohol or recreational drug use
• Pregnancy
• Medications– esp. statins, anticonvulsants, antibiotics (particularly flucloxacillin, erythromycin, doxycycline or co-amoxiclav), paracetamol.
• Herbal treatments

 

 

Investigations

Consider causes and further investigations depending on the type of abnormality:

 

ISOLATED RAISED GGT:

1. Consider causes as below
    
2. If unexplained repeat LFTS + GGT in 1-3 months.
    
3. If still elevated, consider liver USS.

 

Advice and Guidance

Please send advice and guidance requests via e-RS to: http://rms.cornwall.nhs.uk/primary_care_clinical_referral_criteria/rms/primary_care_clinical_referral_criteria/gastro/rcht_hepatology_advice_and_guidance

 

 

Referral

If GGT persistently elevated in isolation with no known cause refer for Hepatology advice and guidance.

 

For East-facing Cornwall practices. Please see South & West Devon DRSS Referral Guidelines

 

 

Supporting Information

For professionals:

• Gut – Guidelines on the Management of Abnormal Liver Blood Tests
• Health Technology Assessment – Birmingham and Lambeth Liver Evaluation Testing Strategies (BALLETS): A Prospective Cohort Study
• RCGP e-learning abnormal LFTS

 

For patients:

• Patient UK – Abnormal Liver Function Tests

 

 

 

Page Review Information

 

Review date	April 2024
Next review date	April 2026
Speciality Lead GP	Dr Madeleine Attridge (Hepatology lead GP)
Contributors	Dr Hyder Hussaini (Consultant Hepatologist RCHT) Anna Barton (Principal Clinical Biochemist)