Having All Over Body Itching. All Test Normal Except SGPT Elevated Levels. Suggest
Best Regards,
XXXXXX
Thank you for posing the query on XXXXXXX
Itching ascribed to liver problems is usually due to an increase in the body of what is called as "direct" or "conjugated" bilirubin. A normal person, when his red cells are recycled, produces very low quantities of bilirubin as a result of the destruction of hemoglobin. This bilirubin is "conjugated" to specific salts by the liver and then removed from the body through the digestive canal. The conjugated bilirubin transforms to a compound known as "stercobilin", which imparts the brown colour to a normal person's stool.
Usually, a risen SGPT is a sign of an inflamed liver. You haven't told me the bilirubin levels. A normal adult has a total bilirubin level of 1 mg/100 ml of blood or less, and most of it is the "indirect or unconjugated" variety. Hence, it will be worthwhile to know what the levels of both the "direct" and the "indirect" bilirubins are in your circulation, so that we can take a call on what is going wrong with your liver.
Kindly revert to me with this information. Please be as detailed as possible, and if you can, please send me scans of all the reports.
Also, was a liver ultrasound and a prothrombin time test ever done? Was a test done for urine? Have you had an "australia antigen" test done? Have you received the hepatitis B vaccine? Did you ever suffer from infective jaundice in the past? Finally, did your doctors ever comment on what they found while examining you ... I am specifically asking you for presence or absence of jaundice in your eyes, a large liver, a large spleen, presence of any fluid in your abdomen, and any other findings they may have found.
As a last help, do tell me if your family members have had liver disease in the past.
I will await your next input.
In the meantime, please don't worry, I will try to unravel the mystery for you, but please send me all the above information. Thank you.
Thanks for your kind reply. I have attached my latest LFT report for your kind reference. The password for opening the file is JALALI
My Direct Bilirubin is : 0.2
Indirect is: 0.6
Total Bilirubin is: 0.8
I have not done prothrombin time test & "australia antigen" test. What are these & what for. I don't know about received or not. Not since I am in senses.
Regarding diagnosis of previous doctors, I had gone to one MD,DM, MRCP Gastro & Herpetologist doctor & other doctor also but they didn't find anything wrong. There was no enlargement of liver, No Fatty Liver, No Jaundice in my eyes. However my ultrasound showed very mild enlargement of spleen.
I don't have Sugar or High BP. My Lipid profile is also normal.
However I am overweight , 80 Kgs with 5'5" height.
I have not undergone ultrasound since last 2 years.
There is no history of any liver disease in my family.
You have rightly called it a mystery disease. A itching disease with elevated SGPT.
Pl. discuss with any of your Gastro colleague also & suggest some medicines for me.
Regards,
XXXXXX
I have seen the uploaded report. SGPT of 93 is not significant clinically. Both SGPT and SGOT are considered significant only when the number is in hundreds like >300.
Therefore, you apparently have no health concern according to me.
Your itching is probably an entirely different issue altogether. Perhaps, it may be due to extremely dry skin or some kind of a contact dermatitis. A Dermatologist could help you better with this.
As of now, you have no existing liver disease as such. So, please relax. Occasional consumption of alcohol is still fine.
Reduce your weight by 5 kgs. Repeat the LFT after 6 months. Hope all should be fine by then.
Prothrombin time is to check the liver function status.
Australia antigen is a test for Hepatitis B.
Take care!
Thanks a lot. Your reply has given me great relief. Earlier doctors had also told me that I don't have any liver disease. They also told me that reduce weight. Now I have last 3 questions?
1. Should I undergo prothrombin time & "australia antigen" tests if necessary? Where to undergo these tests?
2. I am taking sorbiline syrup 10 ml, Udiliv 300 & livomin syrup 10 ml all twice daily since last 10 days. Should I continue them & for how much time?
3. Should I take any diet restrictions like fatty food, oily food, red meat etc.
Thanks again.
Regards,
XXXXXX
I am sorry about the late reply, been a bit busy.
Your answers:
1. Yes, you could undergo the prothrombin time and the australia antigen tests. No harm in doing these tests.
2. Yes, you should continue the medicines. The duration of which, the prescribing doctor could comment on. As he is the doctor treating you and knows how long you need the treatment.
3. Yes, you must avoid fatty food, oily food, red meat. Any high fat food must be avoided.
Hope this helps.
Regards,