Specimen Name Result Units Range
Plasma Albumin 37 g/L (34-48)
Total Protein 68 g/L (60-80)
Total Bilirubin 200 μmol/L (6-24)
GGT 65 U/L (< 60)
ALP 150 U/L (30-110)
ALT 1,050 U/L (< 55)
AST 900 U/L (< 45)

25yo male with fever, malaise and anorexia.
Acute Viral Hepatitis
  • ↑AST:ALT with ratio < 1.0 (N:1.5-2)
    • mild : <200 U/L
    • mod. : <1000 U/L
    • severe : >1000 U/L
    • ** falling levels → improvement or massive necrosis
  • ↑ALP < 2-3x
  • conjugated hyperbilirubinaemia
  • normal or mildly raised globulins
  • hypoalbuminaemia
  • hypoglycaemia
  • ↑INR

 

Hepatitis

  1. infective
    • Hepatitis A, B, C, Delta, E, NANBNC
    • EBV, CMV, HSV, Coxsackie, Yellow fever
  2. drugs
    • cholestasis
      • alcohol
      • chlorpromazine, chloramphenicol, chlorpropamide
      • tetracyclines, erythromycin, rifampicin
      • oestrogens, OCP, androgens
    • hepatitis
      • α-methyl-dopa
      • paracetamol, phenytoin, isoniazid, rifampicin
      • halothane, enflurane, & ? isoflurane
  3. toxins
    • CCl4, vinyl chloride, chloroform
    • Amanita phalloides (mushroom)
  4. cardiovascular
    • ischaemic - hypovolaemic shock, ischaemia
    • congestive - cor pulmonale, RV failure, CCF, Budd-Chiari
  5. metabolic
    • alcohol
    • Wilson's disease (hepatolenticular degeneration)
    • Haemochromatosis
    • α1-antitrypsin deficiency
  6. autoimmune
    • chronic active hepatitis
    • drug induced
    • vasculitis, SLE, UC, PN
    • 1° biliary cirrhosis
  7. pregnancy - acute fatty liver of pregnancy
  8. hyperthermia