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Journals / Turkish Journal of Family Medicine and Primary Care / 2026 / Cilt: 20 Sayı: 3

A Case of Decompensated Cirrhosis Masked by Normal Liver Enzymes

Normal karaciğer enzimleriyle maskelenmiş dekompanse siroz olgusu

Emine Vildan Şahin(Sağlık bakanlığı)0000-0002-3796-2137
Pages
336–339
Publication Date
2026-09-01
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AI Summary & Key Takeaways

AI Insight
⚡ TL;DR(Too Long; Didn't Read)

The case report was prepared and reported in accordance with the CARE (CAse REport) Guidelines.

📌 3 Key Takeaways

🎯
Objective & Hypothesis:Normal levels of liver transaminases do not necessarily exclude cirrhosis.
📊
Key Findings & Data:A case of a 65-year-old female patient is presented who visited with massive variceal bleeding despite having normal transaminase levels in her routine follow-ups.
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Conclusion & Impact:The case report was prepared and reported in accordance with the CARE (CAse REport) Guidelines.
🔬Design:Olgu Sunumu
📍Scope:Comprehensive Sample
⚙️Variables:Karaciğer Transaminazları · Aile Hekimliği · karaciğer sirozo

Abstract

Normal levels of liver transaminases do not necessarily exclude cirrhosis. A case of a 65-year-old female patient is presented who visited with massive variceal bleeding despite having normal transaminase levels in her routine follow-ups. Although the Portal Doppler ultrasound (US) was reported as normal, abdominal US revealed cirrhosis and ascites. This case emphasizes the importance of the aspartate aminotransferase/alanine aminotransferase (AST/ALT) ratio, thrombocytopenia, and Fibrozis-4 (FIB-4) score in the early diagnosis of silent cirrhosis in family medicine, rather than relying solely on transaminase values. The case report was prepared and reported in accordance with the CARE (CAse REport) Guidelines.

Özet

Karaciğer enzimlerinden alanin aminotransferaz (ALT) ve aspartat aminotransferazın (AST) normal sınırlarda olması, kronik karaciğer hastalığını dışlamak için yeterli değildir. Bu olguda, rutin takiplerinde transaminaz düzeyleri normal seyreden ancak masif varis kanaması ile başvuran 65 yaşında bir kadın hasta sunulmaktadır. Hastanın başvuru günü yapılan Portal Doppler ultrasonografi incelemesinin normal olarak raporlanmasına karşın, abdomen ultrasonografisinde asit ve sirotik değişiklikler izlenmiştir. Bu olgu, aile hekimliği pratiğinde sirozun erken tanısında transaminaz değerlerinden ziyade AST/ALT oranı, trombositopeni ve Fibrozis-4 (FIB-4) skoru gibi parametrelerin hayati önemini vurgulamaktadır. Bu olgu sunumunun hazırlanmasında ve raporlanmasında, uluslararası standartlara uyum sağlamak amacıyla CARE (CAse REport) Checklist yönergesi dikkate alınmıştır.

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Cite This Article

Şahin, E. V. (2026). A Case of Decompensated Cirrhosis Masked by Normal Liver Enzymes. Turkish Journal of Family Medicine and Primary Care, Cilt: 20 Sayı: 3, 336–339. https://doi.org/10.21763/tjfmpc.1844183

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