ArticleClinical case reports2026
Isolated Gamma-Glutamyltransferase Elevation During Statin Therapy: A Diagnostic Pitfall and a Stepwise Management Framework to Prevent Unnecessary Discontinuation.
Article in Clinical case reports, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
The management of patients with isolated gamma-glutamyltransferase (GGT) elevation during statin therapy remains a common clinical dilemma due to the unclear relevance to hepatotoxicity. We report a case of a patient with coronary artery disease who developed persistent isolated GGT elevation (> 100 U/L) while on atorvastatin, with normal alanine and aspartate aminotransferase levels. Critically, the elevated GGT persisted after statin withdrawal, and a comprehensive workup revealed uncontrolled cardiometabolic risk factors. We conclude that isolated GGT elevation in this context is more likely a biomarker of underlying cardiovascular risk than of statin-induced liver injury. Based on this case analysis, we propose a stepwise decision framework to guide evaluation and management in such scenarios. Through literature review and case analysis, we conclude that isolated GGT elevation is not a reliable indicator of statin hepatotoxicity and may be associated with cardiovascular risk. Therefore, clinicians should not hastily discontinue statins. Instead, a comprehensive assessment should be initiated to identify potential causes and personalize treatment.
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