Does high gamma glutamyl transpeptidase need treatment Q: My son is 31 years old and was diagnosed with congenital hyperbilirubinemia many years ago, which is normal except for high bilirubin. However, last year, he was found to have γ glutamyl transpeptidase 67.6 (normal 11~50), direct bilirubin 10.2 (0.1~5.0), and total bilirubin 45.8 (3.4~17.1) in his physical examination, and he went to the hospital with no conclusion. A few days ago, we had a physical examination for gamma glutamyl transpeptidase 99.9. We are very anxious, what should we do? What tests should be done? What is the effect on the liver? Do I need treatment? A: Hello, reader Gu! Gamma glutamyl transpeptidase (GGT) is a common enzyme in the evaluation of liver function, and it is widely distributed and is also seen in kidney, pancreas, heart and other tissues in addition to being present in liver tissues. In liver tissues, GGT is mainly found in hepatocytes at the small bile ducts and is often associated with bile duct lesions, so we often call it a “biliary enzyme”. Elevated levels of this enzyme are associated with many hepatobiliary diseases. Commonly, cholestatic diseases, such as primary biliary cirrhosis, autoimmune hepatitis, intrahepatic cholestasis caused by drugs or viruses, biliary obstruction caused by stones or tumors, etc.; also seen in acute and chronic liver damage, such as fatty liver, alcoholic liver, chronic viral hepatitis, etc. In addition, the enzyme is associated with liver fibrosis and is often elevated in patients with liver cirrhosis. Due to its wide distribution, elevated GGT can also be seen in non-liver diseases such as diabetes, kidney damage and myocarditis. Therefore, it is recommended that your son go to the hospital for imaging tests such as ultrasound or CT or MR, liver and kidney function, lipid glucose, and hepatitis B and C virus markers. Your son’s current GGT is only mildly to moderately elevated, probably mostly due to inflammatory liver damage (fatty liver, alcoholic liver, etc.), so there is no need to be overly anxious. After the condition is clear, appropriate treatment will be sufficient.