Oops! I am sorry. I forgot to mention my name in the previous message on
LFT.
Regards
Vivek
Guy's & St.Thoma's
On Wed, 26 Jul 2000, Neely Dermot (RR9) Biochemistry wrote:
> Dear Graham
>
> Results similar to those you describe are encountered very frequently in the
> Lipid Clinic, usually in association with a degree of central obesity and
> hypertriglyceridaemia, which is highly correlated with the degree of hepatic
> steatosis. These people invariably have a bright liver on ultrasound and
> evidence of steatosis or steatohepatitis on biopsy, if they ever get that
> far. Note that the AST:ALT ratio is <1 in NASH, typically >1 in alcoholic
> hepatitis. NASH is now considered by some to be a disorder included in the
> "Syndrome X spectrum". Our liver specialist likes to "read them the riot
> act" on lifestyle which often results in the sort of improvements noted in
> your case. If not, a full work-up to exclude causes of chronic hepatitis is
> required (see recent review in NEJM 2000 342(17): 1266-71 by Pratt,DS and
> Kaplan MM) before consideration of biopsy.
>
> Best wishes
>
> Dermot
>
> -----Original Message-----
> From: Graham Jones [mailto:[log in to unmask]]
> Sent: 25 July 2000 17:24
> To: [log in to unmask]
> Subject: alcohol and GGT
>
>
> Dear colleagues,
>
> I write concerning a patient identified as part of a collection for
> reference intervals. In return for their blood, we returned their results
> with a consultation if required.
>
> One male in his 50s, middle eastern background, possibly carrying a few
> kilograms (don't we all) turned up the following liver function test
> abnormalitites:
> GGT 132 U/L (reference interval <35 U/L), ALT 55 U/L (<30 U/L), AST 33 U/L
> (<30), other LFTs with current reference intervals.
> The only ingested agent which came to light on history was alcohol at about
> 4 standard drinks per week.
> I suggested he abstain and we repeat the tests.
> The repeat GGT after 2 weeks was 70 U/L and ALT was 43 U/L.
> This is a least circumstantial evidence that alcohol may be a causative
> factor in his LFT derangement.
> My questions are as follows:
> 1. Can alcohol at this level (40 g/week) cause these LFT changes, and
> 2. If it can, does this indicate significant damage which should lead to
> alcohol abstinence.
>
> Thank you in advance for your assistance (John Whitfield especially may be
> able to provide some light).
>
> Graham
>
> Graham Jones
>
> Staff Specialist in Chemical Pathology
> St Vincent's Hospital, Sydney, Australia
> Ph: (02) 9361-2170 Fax (02) 9361-2489
>
%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%
|