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These reviews were published in the Journal of Clinical Pathology and a supporting series of cases in the British Medical Journal. See Authors and acknowledgments.

We recommend:

Check liver and bone profiles if not already done, to exclude other raised indices

Isolated raised values up to approximately 20% above the ULN (typically 120 IU/L) are more likely to reflect a statistical rather than clinical finding

If < 1.5 ULN: recheck in 1-3 months

If > 1.5 ULN (2 measurements, 6 months apart): further investigation indicated

If > 3 ULN (single measurement), further investigation indicated