Alcoholic hepatitis laboratory findings: Difference between revisions
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__NOTOC__ | __NOTOC__ | ||
{{Alcoholic hepatitis}} | {{Alcoholic hepatitis}} | ||
{{CMG}}; | {{CMG}}; {{AE}} {{ S.M}} | ||
==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== | == Laboratory Findings== | ||
* | * The [[laboratory findings]] include:<ref name="pmid20954276">{{cite journal| author=Amini M, Runyon BA| title=Alcoholic hepatitis 2010: a clinician's guide to diagnosis and therapy. | journal=World J Gastroenterol | year= 2010 | volume= 16 | issue= 39 | pages= 4905-12 | pmid=20954276 | doi=10.3748/wjg.v16.i39.4905 | pmc=2957598 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20954276 }} </ref><ref name="pmid24876748">{{cite journal| author=Chayanupatkul M, Liangpunsakul S| title=Alcoholic hepatitis: a comprehensive review of pathogenesis and treatment. | journal=World J Gastroenterol | year= 2014 | volume= 20 | issue= 20 | pages= 6279-86 | pmid=24876748 | doi=10.3748/wjg.v20.i20.6279 | pmc=4033465 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24876748 }} </ref> | ||
*:* | ** [[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]]) | |||
*According to National Institute on Alcohol Abuse and Alcoholism (NIAAA), [[Alcoholic Hepatitis]] is diagnosed based on following criteria:<ref> {{cite web |url=https://www.ncbi.nlm.nih.gov/books/NBK470217/ |title=Alcoholic Hepatitis - StatPearls - NCBI Bookshelf |format= |work= |accessdate=}}<ref/> | |||
** Onset of [[jaundice]] within 60 days of heavy [[alcohol]]consumption >50 g/day for at least of 6 [[months]] | |||
** [[Serum bilirubin]] > 3 mg/dL | |||
** [[AST]]level between 50 U/L to 400 U/L | |||
** [[AST]]:[[ALT]] ratio of more than 1.5 | |||
** No other cause of [[acute]] [[hepatitis]] | |||
==References== | ==References== | ||
{{reflist|2}} | {{reflist|2}} | ||
Revision as of 20:53, 30 July 2021
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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:<ref> "Alcoholic Hepatitis - StatPearls - NCBI Bookshelf".
- 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.