liver function levels

    
      Re: liver function levels
    


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Posted by HFHSM.D.-ym on March 18, 1998 at 15:43:50:

In Reply to: liver function levels posted by djf on March 16, 1998 at 18:18:41:
  My son (19) has recently been tested for liver function.  The results indicated high levels of SGPT (111) and Alkiline Phosphates (131). I would like to know what this indicates.
  He often complains of not sleeping well and is often lathargic.  He also has a high triglyceride level (266).  He is 6'7" and weighs approx. 285.  I would appreciate suggestions
  concerning questions I should ask the gastroenterologist.  I want to make sure all bases are covered.  Thank you.
Dear djf,
Liver function test abnormalities are quite common. Liver enzyme elevations are often an indication of liver injury or blockage of the bile ducts (secondary to gallstones or other causes). The liver enzymes called transaminases (SGOT or AST; SGPT or ALT) are usually more elevated with injury to the liver itself and the alkaline phosphatase is usually more elevated in diseases causing cholestasis (diseases which do not allow bile to exit the liver e.g. blockage of bile duct secondary to gallstones). The pattern of liver enzyme elevation can help a gastroenterologist decide which tests to order. However, you should keep in mind that there are many cases where the pattern of liver enzyme elevation does not follow this general rule.
When you take your son to see the gastroenterologist he will probably take a history and perform a physical examination. Most likely he or she will ask your son about new and old medications; vitamin and mineral supplements; herbal preparations and exposure to toxins. He or she will probably also ask some personal questions about alcohol use, previous or current intravenous drug abuse or intranasal cocaine use, sexual behavior, dietary habits or the presence of tatoos or pierced body parts. The answers to these questions are important in directing the gastroenterologist to a certain diagnosis and are not meant to pry into his private affairs. In addition to these questions, the gastroenterologist would be concerned about other family members with a history of liver disorders. On physical exam the gastroenterologist will examine the abdomen to look for signs of liver and spleen enlargement . He or she will also look for other signs of chronic liver disease.
Once the history and physical examination are performed the gastroenterologist may send your son for a series of blood tests to rule out hepatitis or other inherited metabolic disorders of the liver. He or she may also ask your son to have an ultrasound of his abdomen to look for lesions in the liver or evidence of fatty liver and to rule out gallstones. If the blood tests or the ultrasound suggest a certain diagnosis a liver biopsy may be recommended. A liver biopsy is a test where a needle is inserted into the right side of the abdomen in order to actually sample a piece of liver tissue so that a pathologist can determine a microscopic pattern of liver injury. This is an invasive procedure that carries with it some risks. The decision whether to perform a liver biopsy should be one that is made after careful discussion of the risks, benefits and alternatives of the procedure.
Nevertheless, no matter what the diagnosis is, in order to prevent further damage to the liver , it is generally advisable to avoid alcohol consumption, eliminate all unnecessary medications (especially sedatives, high doses of acetaminophen [marketed as Tylenol]), avoid high risk behaviors and to lose weight (if your son is overweight).
I wish  you and your son the best of luck. If you wish to be seen at our institution, I look forward to meeting you personally.
This response is being provided for general informational purposes only and should not be considered medical advice or consultation. Always check with your personal physician when you have a question pertaining to your health.
If you would like to be seen at our institution please call 1-800-653-6568, our Referring Physicians