enlarged liver normal tests

[hamada80]

i had macroscopic hameturia and i did ct abdomen and pelvis.according to report it was normal, later after one and half year radiologist reviewd the ct and find that it was hepatomegally ( increase in size ) about 22 to 23 but other than size liver functions tests was normal at that time.

i remeber that i did us abdomen 14 ys ago and my doc said it seems ur liver is bright ( fatty ) and enlarged i run tests and it was normal and he didnot ask for new tests

what should i do

[hamada80]

thanks you sir

[Thomas D Schiano, MD]

the work-up is OK which indirectly confirms the diagnosis of fatty liver.  i think that you will be OK.

[hamada80]

ok i went to doctor and he ordered the following tests and the results as follow:
1- Imunological study:
a- imunoglobulins:
IgG: 1280 (ref: 805-1570) normal
IgA: 171 (ref: 68- 432 ) normal
IgM: 160 ( ref 46-304 ) normal

b- autoantibodies:imunoflurorescence
- ANA: ( ct ) negative
- SMA : negative
- Anti - mitochondorial : negative
- Anti -endomysial ab: negative

c-Extractable nuclear antigens : ELISA
- C reactive protein  : 1.47 ( ref  < 0.8 ) Positive

d- other autoantibodies :ELISA
- Anti - tTG IgA: negative

2- Complete blood picture:
WBC: 4 ( ref 4- 10 )
RBC : 4.86 (ref 4.5- 5.5)
HGB: 14.1 ( ref 13-17 )
Platlet : 217 ( ref  150 - 450)

differential count :
neutophils : 60% ( ref 40- 70%)
lymphocytes : 39 ( ref 20 -50%)
monocytes : 0 ( ref : 2-10%)
esinophils : 1% ( ref 1- 6%)
basiophils : 0% ( ref 0-1 %)
STAB : 0 % ( ref 0-4%)


3- Liver functions tests:
- SGPT 38  ( ref up to 42 )
- SGOT 29 ( ref up to 37 )

total protein albumin , coagulation profile , alk phosphatase all were normal

but in other lab same day

-SGPT 38 ( ref 0- 33) high
-SGOT 34 ( ref 0- 32) high

NB: my doctor didnot ask for hepatitis c and b because i did them one and half year ago and they were negative ( at the same time that i did the abdominal CT which showed the enlarged liver )

what you think doctor Thomas

[Thomas D Schiano, MD]

the liver can reverse if the damage is due to fatty liver.  i think a gastroenterologist will perform serologic blood testing to exclude other causes of liver disease

[hamada80]

sorry i didnot understand
absolutely  it can return or not
and why should i see gastroenterologist

[Thomas D Schiano, MD]

absolutely if it is due to fatty liver.  You should see a gastroenterologist

[hamada80]

thanks very much . but i am worried about the size 23 in vertical axis
is this size ok with fatty liver and is there any possibility to return to normal size

[Thomas D Schiano, MD]

you appear to have fatty liver--if the liver tests are normal i do not think that you need further work-up but should lose weight or stop drinking alcohol if appropriate

[hamada80]

i forget to mention the hamturia found to be due to infection and resolved in 3 days