GI & Liver » Hepato-biliary-pancreas » Liver & Spleen

Follow up of a patient with abnormal liver function test in OPD

Predominantly raised ALT and AST due to Viral hepatitis, Alcoholic hepatitis, Drug and toxins induced hepatitis, Autoimmune hepatitis, Infiltrative liver disorders, Biliary tract obstruction, Metabolic liver involvement, Hereditary liver disorders Alcoholic liver disease is suggested by daily alcohol consumption of > 40 g in women, > 60 g in men, AST/ALT ratio > 1.5, increased MCV, increased GGT. Drug induced hepatotoxicity most common drugs causing hepatitis in family Practice are NSAIDs, anti convulsants, Anti tubercular drugs, Oral contraceptives steroidal preparations, antiretroviral drugs. Fatty liver - NIDDM, Hyperlipidaemic state, Chronic alcohol abuse, Certain drugs. Usually ALT/AST < 300 I.U. Raised Alkaline Phosphatase > 3 X Normal with raised Serum (Direct / Indirect) bilirubin - Biliary obstruction, ALT markedly increased Chronic autoimmune hepatitis, Chronic viral hepatitis, Haemochromatosis, Wilson's disease.

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