Yellow Tongue and Jaundice?

Question about a chronic yellow discoloration on the middle-back 1/2 of the tongue.  I used to drink pretty heavily but only one time in the last 2 months, last time 1 month ago.

My labs looked fine 1 mth ago (no ETOH since getting these labs done):

LDH 145
AST 25
ALT 38
(AST/ALT < 1.0)
GGT 22
Alk Phos 25
ALB 4.5
GLOB 2.9
TP 7.4
TBili 0.9
TRIG 87
Entire Lipid Profile Good (Cardiac Risk < 0.5)
WBC 5.8
CBC WNL
Urine Bili NEG
Urobilinogen 0.2

The concern is could the yellow tongue discoloration be due to liver dysfunction with the serum bilirubin 0.9, albumin 4.5, no urine bilirubin, etc . . . as above?

I had a HX of "mild" fatty liver and "mild" non-specific reactive hepatitis ("a few clumps of WBC's" on liver biopsy) in July, but thought that should resolve with no ETOH.

Could there be other causes, tobacco stain . . .?

[Kevin Pho, MD]

It would be unlikely that jaundice is present with a bilirubin of 0.9.  

Possible causes would include oral thrush - which can be cultured for and treated with an antifungal medication.

Another possibility would be something called hairy oral leukoplakia, which is associated with immunocompromise and Epstein-Barr virus.  This can present with white plaques on the tongue.

If there continues to be confusion as to the lesions, a referral to an oral surgeon for possible biopsy can be considered.

Followup with your personal physician is essential.

This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.

Kevin, M.D.
Medical Weblog:
kevinmd_b