An orthopedic surgeon at the Hospital for Sick Children once wrote
about what he called the "Ulysses Syndrome".  This is where a blood
test is done, usually for no good reason (except "screening") and an
elevated AST (SGOT) is found.  There then follows a long winding
search which lasts for a long time to try to find the cause of this,
wasting everyone's time and money.  This looks a little like this.

About 15 years ago, a movie called the Hospital came out.  It was
fairly funny, though a bid morbid.  In the hospital is a man who got
there this way.  He went for an insurance physical.  He has an
abnormal urinalysis.  From there, the Ulysses Syndrome leads him
eventually to a kidney biopsy, even though he is healthy.  He bleeds,
goes into shock, and eventually is comatose and dying.  Great!

Question?  How many tests do you need to have to have a 50% chance of
getting one abnormal, even though you are perfectly normal?  14 (serum
electrolytes count for at least 3, for example).

What is the significance of elevated liver enzymes and nothing else?
Nobody knows.  Forget it.

Jack Newman, MD, FRCPC