Diagnosis of primary sclerosing cholangitis in a blood donor with elevated serum alanine aminotransferase.

At routine blood donation, a 37-yr-old man with an elevated serum alanine aminotransferase was found to have primary sclerosing cholangitis. The majority of asymptomatic blood donors with elevated aminotransferase levels are presumed to have fatty liver or chronic non-A, non-B hepatitis. However, a substantial number of blood donors with elevated aminotransferase levels will have other hepatobiliary diseases, including primary sclerosing cholangitis. The implementation of aminotransferase screening of blood donors should result in earlier diagnosis, better understanding of natural history, and occasionally, earlier treatment of a number of hepatobiliary diseases.