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<p>Glutamate dehydrogenase (GLDH) is an enzyme located predominantly in the mitochondria of hepatocytes and is measured far less frequently in routine practice than conventional liver tests. An isolated elevation of GLDH despite otherwise normal standard liver parameters, such as alanine aminotransferase (ALT), aspartate aminotransferase (AST), gamma-glutamyltransferase (GGT), bilirubin, alkaline phosphatase (ALP), cholinesterase (CHE), albumin or international normalized ratio (INR) can therefore lead to considerable diagnostic uncertainty. The key question is whether this finding reflects clinically relevant hepatocellular injury, particularly mitochondrial injury, a&#xa0;transient phenomenon, or a&#xa0;preanalytical or analytical artifact. This article summarizes the biochemical background, occurrence and diagnostic characteristics of GLDH in comparison to transaminase-based parameters. The focus is on a&#xa0;practical algorithm for systematic result validation and risk-adapted evaluation based on course control, clinical warning signs, targeted laboratory diagnostics and imaging. The aim is to avoid overdiagnosis while reliably identifying relevant causes of isolated GLDH elevation.</p>

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Isolierte GLDH-Erhöhung – harmlos oder abklärungsbedürftig?

  • 期刊论文

  • 发表日期：

    2026年6月3日

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  • Jasmin Weninger,
  • Michael Pohl,
  • Mustafa Özçürümez,
  • Ali Canbay

摘要

Glutamate dehydrogenase (GLDH) is an enzyme located predominantly in the mitochondria of hepatocytes and is measured far less frequently in routine practice than conventional liver tests. An isolated elevation of GLDH despite otherwise normal standard liver parameters, such as alanine aminotransferase (ALT), aspartate aminotransferase (AST), gamma-glutamyltransferase (GGT), bilirubin, alkaline phosphatase (ALP), cholinesterase (CHE), albumin or international normalized ratio (INR) can therefore lead to considerable diagnostic uncertainty. The key question is whether this finding reflects clinically relevant hepatocellular injury, particularly mitochondrial injury, a transient phenomenon, or a preanalytical or analytical artifact. This article summarizes the biochemical background, occurrence and diagnostic characteristics of GLDH in comparison to transaminase-based parameters. The focus is on a practical algorithm for systematic result validation and risk-adapted evaluation based on course control, clinical warning signs, targeted laboratory diagnostics and imaging. The aim is to avoid overdiagnosis while reliably identifying relevant causes of isolated GLDH elevation.