Aminotransferase levels may also be markedly high in the following: Acute exacerbation of autoimmune hepatitis Reactivation of chronic hepatitis B Acute Budd-Chiari syndrome Acute fatty liver of pregnancy Passage of a common duct stone Acute Wilson disease Drug - or toxin-induced liver disease Modest elevations (300 to 500 IU / L) persist in chronic liver disorders (eg, chronic hepatitis) and in biliary obstruction, except when passage of a common duct stone can transiently result in markedly high levels.