Elevated Gamma-Glutamyl Transferase: Causes and Treatment Options

Elevated gamma-glutamyl transferase (GGT) levels are often associated with liver cell damage or injury to the epithelial cells of the bile ducts. This condition is commonly caused by alcoholic or drug-induced hepatitis, viral hepatitis, and biliary obstructive diseases. It is recommended to seek medical attention promptly to identify the underlying cause and begin appropriate treatment.

Common Causes and Treatment Approaches

1. Alcoholic or Drug-Induced Hepatitis

If liver function tests show elevated GGT levels without other abnormalities, it may be due to alcoholic hepatitis from long-term alcohol consumption or drug-induced hepatitis from liver-damaging medications. In such cases, discontinuing alcohol intake and stopping the causative medication may lead to a decrease in GGT levels over time. In mild cases, no specific treatment may be necessary, and regular follow-up testing is sufficient. However, if symptoms such as jaundice, abdominal distension, diarrhea, or skin itching appear, hospitalization may be required for more intensive care.

2. Viral Hepatitis

Viral hepatitis caused by different types of hepatitis viruses can also lead to increased GGT levels. Blood tests often reveal elevated bilirubin, decreased serum albumin, and increased globulin levels. The four most common types—HAV, HBV, HCV, and HEV—each have distinct treatment approaches:

- Hepatitis A: Typically does not require antiviral therapy. Liver-protecting medications such as hepatoprotective tablets or compound glycyrrhizin injections may be prescribed under medical supervision.
- Hepatitis B: Patients are often treated with antiviral drugs such as lamivudine, entecavir, or telbivudine. Interferon therapy may be considered for younger patients, those planning to conceive, or individuals seeking short-term treatment.
- Hepatitis C: Antiviral medications like sofosbuvir and glecaprevir are commonly used. Successful treatment is confirmed when HCV RNA is undetectable in the blood after therapy.
- Hepatitis E: Antiviral treatment is generally not required. Supportive care with non-specific liver protectants such as vitamins and glucuronic acid may be provided.

3. Biliary Obstructive Diseases

Conditions such as gallstones or bile duct obstruction can significantly increase GGT levels—sometimes more than ten times the normal reference range. Patients are advised to seek prompt medical evaluation, including abdominal CT scans. Once biliary obstruction is confirmed, surgical intervention is typically necessary to resolve the blockage.