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Complaining Of Stomach Pain. Suggested Several Blood & Liver Function Tests. Report SGOT (AST) Of 41 & SGPT (ALT) Of 93. Suggest?
Question: My son is studying at an Engineering College which is located at a fairly remote place, where hygienic food & clean drinking water is a problem. He was complaining of stomach pains for which the Doctor has prescribed several Blood & Liver function tests. His Report indicates SGOT (AST) of 41 & SGPT (ALT) of 93. His Neurophils count is 68. What does these indicate ? Are they at seriously high levels ? Also, what diet he should follow at this time ?
Hello,
Thanks for posting on XXXXXXX
I am pleased to be able to help you.
Let me start by providing you with this information:
The references ranges for
- AST (males): 6-34 IU/L and your son's value is 93
- ALT: 20-60 IU/L and his value is 41
- % Neutrophils is 68% which is within normal range (but strictly speaking is not really of much clinical significance without giving the complete neutrophil count and also indicated their white blood cells differentials i.e showing other cell counts).
AST and ALT are liver enzymes and can indirectly interpret if there is any liver problems such as acute viral hepatitis, fatty liver diseases, systemic infection etc. So the results shows that your son's liver function is altered with elevated liver transaminases. The doctor will need to complete the tests first by doing screening for Hepatitis B and C.
Then locating the site of stomach pain is also of much clinical value and will help oriented as to the cause and also subsequent treatment. Your son might also require abdominal ultrasound and/or CT scan or MRI.
His diet will depend mostly on the actual cause (if at all that will require any diet change). Generally he might need to reduce fat consumption, avoid alcohol, avoid drugs that may cause diet to the liver etc.
He will also require to see a gastroenterologist for thorough review and follow-up.
Hope this helps and let me know if you have any other questions.
Dr. Nsah
Thanks for posting on XXXXXXX
I am pleased to be able to help you.
Let me start by providing you with this information:
The references ranges for
- AST (males): 6-34 IU/L and your son's value is 93
- ALT: 20-60 IU/L and his value is 41
- % Neutrophils is 68% which is within normal range (but strictly speaking is not really of much clinical significance without giving the complete neutrophil count and also indicated their white blood cells differentials i.e showing other cell counts).
AST and ALT are liver enzymes and can indirectly interpret if there is any liver problems such as acute viral hepatitis, fatty liver diseases, systemic infection etc. So the results shows that your son's liver function is altered with elevated liver transaminases. The doctor will need to complete the tests first by doing screening for Hepatitis B and C.
Then locating the site of stomach pain is also of much clinical value and will help oriented as to the cause and also subsequent treatment. Your son might also require abdominal ultrasound and/or CT scan or MRI.
His diet will depend mostly on the actual cause (if at all that will require any diet change). Generally he might need to reduce fat consumption, avoid alcohol, avoid drugs that may cause diet to the liver etc.
He will also require to see a gastroenterologist for thorough review and follow-up.
Hope this helps and let me know if you have any other questions.
Dr. Nsah
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thanks Dr. Nsah for your reply.
After going thru your comments, I noticed later that the Tests also covered Complete Hemogram & Bilirubin Tests, the Readings are as follows :
Complete Hemogram:
-------------------
Haemoglobin : 16.8, Total Leucocyte Count : 9,600 /cumm
Differential Leucocyte Count
---------------------------
Neutrophils : 68% (already informed earlier), Lymphocytes : 20%, Eosinophils : 04%, Basophils : 0, Monocytes: 08%, Band Forms : 0
Absolute Counts :
----------------
Absolute Neutrophils Count : 6528 / Cumm
Absolute Lymphocyte Count : 1920/Cumm
Absolute Eosinophil Count : 384/ Cumm
Absolute Basophil Count : 00
Absolute Monocyte Count : 768/Cumm
Platelet Count : 215,000/cumm
Red Blood Cell Count : 5.64 Million/cumm
ESR (Wintrobe) : 07 mm 1st Hour
Packed Cell Volume : 48.9%
MCV Value : 86.7 fl
MCH : 29.8 pg
MCHC : 34.4 %
Red Cell Distribution Width : 46.8 fl
Peripheral Blood Smear:
----------------------
RBC's Normocytic Normochromic
WBC's show relative Neutrophilia
Platelets are seen singly and in few aggregates and appear adequate in number.
No Immature Cells seen.
Impression :
----------
Relative Neutrophilia
RENAL Function Test Report
---------------------------
Blood Urea : 35 mg/dl
S.Creatinine : 1.11 mg/dl
Uric Acid : 7.10 mg/dl
Sodium : 147 meq/l
Potassium : 3.9 meq/l
Urine Microalbumin : 30.4 mg/dl
----
Bun/Creatinine Ratio : 14.73
Estimated Glomerular Filtration Rate : 88.0 ml/min/1.73 m2
LIVER Function Test Report
--------------------------
S.Bilirubin (Total) : 2.05 mg/dl
S.Bilirubin (Direct/Conjugated) : 0.46 mg/dl
S.Bilirubin (InDirect/UnConjugated): 1.59 mg/dl
SGOT (AST) : 41 IU/L
SGPT (ALT) : 93 IU/L
Alkaline Phosphatase : 125 IU/L
Total Proteins : 7.2 gm/dl
Albumin : 4.6 gm/dl
Globulin : 2.6 gm/dl
A:G Ration : 1.77
Gamma GT 37 U/L
THYROID FUNCTION Tests
-------------------------
TSH : 3.01
Also done URINE Routine Examination
-----------------------------------
All values appear within Normal Range. Color is : Pale Yellow.
(I had Hepatitis once and I remember the Urine had become very dark yellow).
Please let me know if the above values will help you make a more accurate judgement.
It is clear to me that there are some problems with his Liver, as you have already intimated. As he does not drink nor is on any prolonged medication, the most likely cause to me appears to be from drinking contaminated water or oily/fatty food. What I want to know are as follows :
a) Has he contracted any strain of Hepatisis already ?
b) I have already provided him with a XXXXXXX Iodine Water Filter which fits onto a Tap, so that he can have atleast some protection (other Water Filters would require Electricity which is not permitted inside the Hostel where he stays). Hope Iodine is not going to aggravate his condition ?
c) Diet : The only "relatively safe" food available there are all packaged ones like : Milk,Yogurt, XXXXXXX noodles and Biscuits and maybe some fruits like bananas. There are no eateries around which can serve even "remotely" healthy food which are having low oil content. So can he have all the packaged foods mentioned ?
Regards XXXXXXX XXXXXXX
After going thru your comments, I noticed later that the Tests also covered Complete Hemogram & Bilirubin Tests, the Readings are as follows :
Complete Hemogram:
-------------------
Haemoglobin : 16.8, Total Leucocyte Count : 9,600 /cumm
Differential Leucocyte Count
---------------------------
Neutrophils : 68% (already informed earlier), Lymphocytes : 20%, Eosinophils : 04%, Basophils : 0, Monocytes: 08%, Band Forms : 0
Absolute Counts :
----------------
Absolute Neutrophils Count : 6528 / Cumm
Absolute Lymphocyte Count : 1920/Cumm
Absolute Eosinophil Count : 384/ Cumm
Absolute Basophil Count : 00
Absolute Monocyte Count : 768/Cumm
Platelet Count : 215,000/cumm
Red Blood Cell Count : 5.64 Million/cumm
ESR (Wintrobe) : 07 mm 1st Hour
Packed Cell Volume : 48.9%
MCV Value : 86.7 fl
MCH : 29.8 pg
MCHC : 34.4 %
Red Cell Distribution Width : 46.8 fl
Peripheral Blood Smear:
----------------------
RBC's Normocytic Normochromic
WBC's show relative Neutrophilia
Platelets are seen singly and in few aggregates and appear adequate in number.
No Immature Cells seen.
Impression :
----------
Relative Neutrophilia
RENAL Function Test Report
---------------------------
Blood Urea : 35 mg/dl
S.Creatinine : 1.11 mg/dl
Uric Acid : 7.10 mg/dl
Sodium : 147 meq/l
Potassium : 3.9 meq/l
Urine Microalbumin : 30.4 mg/dl
----
Bun/Creatinine Ratio : 14.73
Estimated Glomerular Filtration Rate : 88.0 ml/min/1.73 m2
LIVER Function Test Report
--------------------------
S.Bilirubin (Total) : 2.05 mg/dl
S.Bilirubin (Direct/Conjugated) : 0.46 mg/dl
S.Bilirubin (InDirect/UnConjugated): 1.59 mg/dl
SGOT (AST) : 41 IU/L
SGPT (ALT) : 93 IU/L
Alkaline Phosphatase : 125 IU/L
Total Proteins : 7.2 gm/dl
Albumin : 4.6 gm/dl
Globulin : 2.6 gm/dl
A:G Ration : 1.77
Gamma GT 37 U/L
THYROID FUNCTION Tests
-------------------------
TSH : 3.01
Also done URINE Routine Examination
-----------------------------------
All values appear within Normal Range. Color is : Pale Yellow.
(I had Hepatitis once and I remember the Urine had become very dark yellow).
Please let me know if the above values will help you make a more accurate judgement.
It is clear to me that there are some problems with his Liver, as you have already intimated. As he does not drink nor is on any prolonged medication, the most likely cause to me appears to be from drinking contaminated water or oily/fatty food. What I want to know are as follows :
a) Has he contracted any strain of Hepatisis already ?
b) I have already provided him with a XXXXXXX Iodine Water Filter which fits onto a Tap, so that he can have atleast some protection (other Water Filters would require Electricity which is not permitted inside the Hostel where he stays). Hope Iodine is not going to aggravate his condition ?
c) Diet : The only "relatively safe" food available there are all packaged ones like : Milk,Yogurt, XXXXXXX noodles and Biscuits and maybe some fruits like bananas. There are no eateries around which can serve even "remotely" healthy food which are having low oil content. So can he have all the packaged foods mentioned ?
Regards XXXXXXX XXXXXXX
Hello XXXXXXX
Thanks for updating,
Let me start by interpreting the results to you in a simple way.
His complete hemogram appears to be normal (beside the relative neutrophilia/relative low neutrophile count which is no major issue but to an extend could be interpreted as low immunity-but as they mentioned it is relative, meaning it could rise back later if the test is redone). His thyroid and renal function are all normal. The only test that appear to have a little problem is the LFT which I already explained in details what it might entail.
Now to answer your question,
a) It is not possible to tell if he has contracted any strains of hepatitis or not given just the above results. Specific tests such to screen for strains of hepatitis should be done to exclude viral hepatitis
b) Iodine has no deteriorating effect on his liver and could instead be beneficial to his system
c) The diet you mentioned is fine by me and he might need to sick local expert's advise when it comes to food.
Hope I was able to provide you with much reliable information.
Dr. Nsah
Thanks for updating,
Let me start by interpreting the results to you in a simple way.
His complete hemogram appears to be normal (beside the relative neutrophilia/relative low neutrophile count which is no major issue but to an extend could be interpreted as low immunity-but as they mentioned it is relative, meaning it could rise back later if the test is redone). His thyroid and renal function are all normal. The only test that appear to have a little problem is the LFT which I already explained in details what it might entail.
Now to answer your question,
a) It is not possible to tell if he has contracted any strains of hepatitis or not given just the above results. Specific tests such to screen for strains of hepatitis should be done to exclude viral hepatitis
b) Iodine has no deteriorating effect on his liver and could instead be beneficial to his system
c) The diet you mentioned is fine by me and he might need to sick local expert's advise when it comes to food.
Hope I was able to provide you with much reliable information.
Dr. Nsah
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
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