LFT-Case-Study

(text-style:"underline")[''Case Study''] Mr. John Doe, a 52-year-old male, presents with fatigue, mild jaundice, and weight loss (5kg over 6 months). His LFT results are: ALT - 145 U/L (reference range: 7-56 U/L) AST - 320 U/L (reference range: 10-40 U/L) AST/ALT Ratio - 2.2 (reference range: <1.0) ALP - 110 U/L (reference range: 40-129 U/L) GGT - 98 U/L (reference range: 8-61 U/L) Total Bilirubin - 2.1 mg/dL (reference range: 0.1-1.2 mg/dL) Direct Bilirubin - 1.4 mg/dL (reference range: <0.3 mg/dL) Albumin - 3.1 g/dL (reference range: 3.5-5.0 g/dL) Do these results show any abnormalities? [[No]] [[Yes]]

Are you sure? Take another look! Return to [[Case Study ]]

What results would you like at in further detail? [[Assess ALT & AST Levels]] [[Assess ALP & GGT]] [[Assess Bilirubin]] [[Assess Albumin & Coagulation]]

ALT & AST are markers of liver cell damage. ''Patient Results'' ALT - 145 U/L (reference range: 7-56 U/L) AST - 320 U/L (reference range: 10-40 U/L) AST/ALT Ratio - 2.2 (reference range: <1.0) If both are elevated, this is indicative of heptaocellular injury. If the AST/ALT ratio is > 2.0, this strongly suggests Alcoholic Liver Disease. The next step would be to investigate [[Alcohol History]]

ALP & GGT tests are used to distinguish cholestasis versus liver cell injury. ''Patient Results'' ALP - 110 U/L (reference range: 40-129 U/L) GGT - 98 U/L (reference range: 8-61 U/L) If the ALP is normal, this indicates no significant bile duct obstruction. If the GGT is elevated, this suggests alcohol-related liver disease. Does the patients results support a diagnosis of cholestasis? What would you like to do next? [[Assess ALT & AST Levels]] [[Assess Bilirubin]] [[Assess Albumin & Coagulation]] [[Assess the Final Diagnosis & Treatment Plan]]

Testing bilrubin allows liver excretion function to be asessed. ''Patient Results'' Total Bilirubin - 2.1 mg/dL (reference range: 0.1-1.2 mg/dL) Direct Bilirubin - 1.4 mg/dL (reference range: <0.3 mg/dL) If both total and direct bilirubin levels are elevated, this is an indication of direct (conjugated) hyperbilirubinemia. The next steps would be to perfom an [[ultrasound]] to assess if the patient has cirrhosis.

Assessing the albumin levels allows for liver synthetic function to be measured. ''Patient History'' Albumin - 3.1 g/dL (reference range: 3.5-5.0 g/dL) If the albumin level is low, then this is indicative of chronic liver dysfunction. An INR test was conducted to look further into coagulation. The INR for this patient was 1.8, indicating impaired liver protein synthesis. What would you like to do next? [[Assess ALT & AST Levels]] [[Assess ALP & GGT]] [[Assess Bilirubin]] [[Assess the Final Diagnosis & Treatment Plan]]

The patient reports drinking 4-5 beers daily for 15 years. How does this fit into your diagnosis of the patient? What would you like to do next? [[Assess ALP & GGT]] [[Assess Bilirubin]] [[Assess Albumin & Coagulation]] [[Assess the Final Diagnosis & Treatment Plan]]

(text-style:"underline")[''Final Diagnosis: ''] Alcoholic Hepatitis with Possible Early Cirrhosis (text-style:"underline")[''Management Plan:''] 1. Immediate Alcohol Cessation – Referral to addiction support. 2. Nutritional Therapy – High-protein diet, Vitamin B1 (Thiamine), Folate. 3. Liver Imaging (Fibroscan/Elastography) – To confirm fibrosis stage. 4. Monitoring & Follow-up – Repeat LFTs in 4-6 weeks. 5. Consider Liver Biopsy – If fibrosis remains unclear.

Ultrasound Findings: - Coarse liver texture (suggesting fibrosis) - Mild splenomegaly (possible portal hypertension) - No bile duct dilation (confirming no obstruction) Does this confirm your diagnosis? What would you like to do next? [[Assess ALT & AST Levels]] [[Assess ALP & GGT]] [[Assess Albumin & Coagulation]] [[Assess the Final Diagnosis & Treatment Plan]]