Evidence map›Paper›PMID 37269372›Full record

SynthesisDigestive diseases and sciences2023

Choledocholithiasis Can Present with Marked Transaminases Elevation: Systematic Review and Meta-Analysis.

Mouhand F H Mohamed, Khaled Elfert, Neha Wadhavkar, Daniel Marino, Kanhai Farrakhan, Azizullah Beran, Mohamed A Abdallah, Abubaker Abdalla, Ronan Farrell

Abstract readMeta-AnalysisSystematic Review
PubMed Publisher
In one paragraph

Synthesis in Digestive diseases and sciences, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
1.8field-weighted citation impact, top 14% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed, 7 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 5 institutions in 1 country.

Mouhand F H MohamedDivision of Medicine, The Warren Alpert Medical School of Brown University, 593 Eddy Street, Providence, RI, 02903, USA. mouhand@brown.edu.ORCID http://orcid.org/0000-0002-4761-8014
Khaled ElfertDepartment of Medicine, SBH Health System, New York, NY, USA.
Neha WadhavkarDivision of Medicine, The Warren Alpert Medical School of Brown University, 593 Eddy Street, Providence, RI, 02903, USA.
Daniel MarinoDivision of Medicine, The Warren Alpert Medical School of Brown University, 593 Eddy Street, Providence, RI, 02903, USA.
Kanhai FarrakhanDivision of Gastroenterology, The Warren Alpert Medical School of Brown University, Providence, RI, USA.
Azizullah BeranGastroenterology and Hepatology Department, Indiana University, Indianapolis, IN, USA.
Mohamed A AbdallahDivision of Gastroenterology, University of Minnesota, Minneapolis, MN, USA.
Abubaker AbdallaDivision of Digestive Disease, Emory University, Atlanta, GA, USA.
Ronan FarrellDivision of Gastroenterology, The Warren Alpert Medical School of Brown University, Providence, RI, USA.
Brown University · USEmory University · USIndiana University – Purdue University Indianapolis · USNorthwell Health · USUniversity of Minnesota · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundExtreme transaminase elevation > 1000 international units per liter (IU/L) is typically caused by hepatocellular injury due to ischemia, drugs, or viral infection. Acute choledocholithiasis can also present with marked transaminase elevation mimicking severe hepatocellular injury, contrary to the presumed cholestatic pattern.

methodsWe searched PubMed/Medline, EMBASE, Cochrane Library, and Google Scholar for studies reporting the proportion of marked elevation of alanine aminotransferase (ALT) or aspartate aminotransferase (AST) > 1000 IU/L in patients with common bile duct (CBD) stones. A proportion meta-analysis with a corresponding 95% confidence interval (CI) was used to pool the proportion of patients with extreme transaminase elevation. I

resultsThree studies (n = 1328 patients) were included in our analysis. The reported frequency of ALT or AST > 1000 IU/L in choledocholithiasis patients ranged between 6 and 9.6%, with pooled frequency of 7.8% (95% CI 5.5-10.8%, I

conclusionThis is the first meta-analysis to study prevalence of severe hepatocellular injury in patients with CBD stones. Results revealed that approximately one-third of patients with choledocholithiasis present with ALT or AST > 500 IU/L. Furthermore, levels > 1000 IU/L are not uncommon. An elaborate work-up for alternative etiologies of severe transaminase elevation is likely unwarranted in cases with clear evidence of choledocholithiasis.

Indexed as

CholedocholithiasisGallstonesAlanine TransaminaseAspartate AminotransferasesHumansLiver Function TestsAlanine TransaminaseAspartate AminotransferasesCBDCholedocholithiasisGallstoneLiver injurySevere transaminase

Identifiers

PMID37269372
OpenAlexW4379209571

What OpenQuestion holds

Textmetadata
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.