Eight of 50 patients with serum ALT exceeding two-fold ULN had a clinical condition that could explain liver enzyme elevation: cholecystitis (n = 1), pancreatic cancer (n = 1), sepsis involving multiple organs (n = 4), cardiac failure with hepatic congestion (n = 1), and a patient receiving treatment for tuberculosis (n = 1). The gene discussed is GPT; the disease is heart failure.