Alcoholic hepatitis laboratory findings
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Shadan Mehraban, M.D.[2]
Overview
The most frequent laboratory findings of Alcoholic hepatitis include neutrophilic leukocytosis with bandemia,anemia ,AST/ALT ratio greater than 2, mild elevation of Alkaline Phosphatase, hypoalbuminemia, hyperbilirubinemia,prolonged prothrombin time, and elevated gamma-glutamyl transpeptidase level.
Laboratory Findings
- The laboratory findings include:[1][2]
- Complete blood count (CBC) shows:
- Neutrophilic leukocytosis with bandemia
- Anemia
- Increased mean corpuscular volume (MCV)
- Thrombocytosis as part of inflammatory process or thrombocytopenia as a result of splenic sequestration
- Liver tests shows:
- Aspartate aminotransferase (AST)level is elevated to 2–6 times the upper limit of normal
- AST/ALT (alanine aminotransferase) ratio greater than 2
- Mild elevation of Alkaline Phosphatase (ALP)
- ALP level of more than 500 U/L is suggestive of infiltrative or biliary obstructive disease
- Elevated gamma-glutamyl transpeptidase (GGTP) level
- Hypoalbuminemia
- Hyperbilirubinemia
- Prolonged prothrombin time (PT)
- The severity of hyperbilirubinemia and coagulopathy are indicative of severity of Alcoholic Hepatitis
- Blood tests in order to exclude other diseases:
- Hepatitis B surface antigen (HBsAg)
- Anti–hepatitis C virus
- Ferritin and transferrin to exclude hemochromatosis
- Alpha-fetoprotein (AFP) to exclude hepatocellular carcinoma (HCC)
- Complete blood count (CBC) shows:
- According to National Institute on Alcohol Abuse and Alcoholism (NIAAA), Alcoholic Hepatitis is diagnosed based on following criteria:[3]
- Onset of jaundice within 60 days of heavy alcoholconsumption >50 g/day for at least of 6 months
- Serum bilirubin > 3 mg/dL
- ASTlevel between 50 U/L to 400 U/L
- AST:ALT ratio of more than 1.5
- No other cause of acute hepatitis
References
- ↑ Amini M, Runyon BA (2010). "Alcoholic hepatitis 2010: a clinician's guide to diagnosis and therapy". World J Gastroenterol. 16 (39): 4905–12. doi:10.3748/wjg.v16.i39.4905. PMC 2957598. PMID 20954276.
- ↑ Chayanupatkul M, Liangpunsakul S (2014). "Alcoholic hepatitis: a comprehensive review of pathogenesis and treatment". World J Gastroenterol. 20 (20): 6279–86. doi:10.3748/wjg.v20.i20.6279. PMC 4033465. PMID 24876748.
- ↑ "Alcoholic Hepatitis - StatPearls - NCBI Bookshelf".