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What Does The Following Blood Test Report Indicate?

Posted on Thu, 16 Oct 2014

Question: I wanted to ask your opinion about a series of tests that my mom underwent this week. The series of the events are as follows:
She had a routine blood test including LFT. Her LFT values (that were not in range) were as follows:
GGTP- 731 U/l
Alkaline Phosphatase (ALP)- 305 U/l
AST (SGOT)- 63 U/l
ALT (SGPT)- 58 U/l
Rest all values are normal in LFT and CBC. She has also been tested negative for Hepatitis B, C and HIV.
Then we got an ultrasound done of her liver. The report mentioned "liver seen of darker in echopattern with some coarse granularity"
Today, we also got the Fibroscan done of her liver. To summarize the report findings:
Median is 11.0 kPa
IQR is 0.9
IQR/med is 8%
According to her Fibroscan report, is it early Fibrosis? Is it reversible? Also, what should be the next steps?
Patient's Brief Medical History:
She is non-alcoholic, 60 years old asthmatic for past 20 years. She also suffers from Osteoporosis- that was diagnosed a year back; her T-score back then was -2.4. She also suffers from chronic headaches and has been taking pain-killers off and on.
Thanks a lot for all your help.

Answered by Dr. Dr Samir Patil (10 hours later)

Brief Answer:
get ANA and ceruloplasmin done. exercise and vit E

Detailed Answer:
Hello,
I have read your description and seen the reports
Your mother has almost1.5 times elevated liver enzymes.this suggests inflammation in the liver.
I would advise to get ANA and serum ceruloplasmin tests done to look for autoimmune hepatitis and Wilson's disease. (Rare but treatable). In case these are negative then In would keep her diagnosis as XXXXXXX ( non alcoholic steatohepatitis)
In case the above tests are negative ,I would suggest shot and sgpt every 3 months. Invade they continue to increase we might need to consider whether to do a liver biopsy.
Fibroscan suggests there might be fibrosis. Early fibrosis could be reversible.
I would suggest
Daily regular exercise
Avoid fried, fast food, and simple carbohydrates like sweets
And vitamin E

Hope this helps,
Do get back in case you have further queries
Regards
Dr Samir Patil

Above answer was peer-reviewed by : Dr. Yogesh D

Follow up: Dr. Dr Samir Patil (5 hours later)

Thanks for your reply. We have already gotten her AMA test done. The results are expected by 26th August. I have a follow-up question.

She has also been taking the following medicines:

1) Tab D-Veniz 100 mg
2) Tab Tryptomer 25 mg
3) Tab Etizoram 0.5 mg
4) Tab Etoshine 90 mg (SOS)

If the pain doesn't subside she has often taken Proxyvon as a pain killer.

Like I mentioned, all her LFT lab results were fine as late as 16th August. Does it mean that one of the above medicines can cause inflammation? And if that is the case, will it be reversible?

In general, she hasn't lost her appetite in the past month or so. She is in good health with her Hb level at 11. She has also not experienced any itching.

Appreciate your help.
Thanks.

Answered by Dr. Dr Samir Patil (4 hours later)

Brief Answer:
if due to drugs then its reversible

Detailed Answer:
Of all the medications tryptomer can cause raised enzymes ( seen in 10 %)but the effect is rarely severe. And it is reversible
If possible I would consider switching tryptomer to some other medication if the pending labs are negative. please consult your doctor regarding this. The chances of raised liver enzymes being caused by the other meds is very rare ( < 1 %)
Hope this helps
Regards
Dr Samir Patil

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Above answer was peer-reviewed by : Dr. Bhagyalaxmi Nalaparaju