35 year old male had Gallbladder full of stones removed 5/88.
Stones were removed from cystic duct and common bile duct as well.
The pancreas was moderately thickined with edematous pancreatitis with no evidence of hemorrhagic pancreatitis and no saponification.
Blood work before surgery showed no elevations in any of the liver tests.High triglycerides (254) and normal cholesteral (181) were noted.
Currently 45 years old and has visited doctors quite a few times over the last ten years with complaints of fatigue and inability to return to robust health enjoyed prior to surgey.
Has gained approximately 20 pounds since surgery and has held consistent for several years at 195 lbs (5' 9" height).
Blood work 7/96 showed elevations in Gamma GT (205 u/l), sgot(99 u/l),sgpt (113 u/l), total protein(9.1 g/dl), cholesteral (255 mg/dl), triglycerides (839 mg/dl), ferritin (378 ng/dl), and EBV VCA-IGG > 170 AU.
Abdominal CT Scan 7/96 was unremarkable.
Liver Ultrasound 5/97 noted no masses with mild fatty infiltration.
Blood work 6/97 continued to show elevated liver panel: Cholesteral(209), Triglycerides (207), SGPT (61), and Gamma GT (120).AFP, Tumor Marker (2.4 NG/ML).
Current blood work (9/98) continues to show elevated triglycerides (274), Cholesteral (227), and Gamma GT (156) as well as sodium (148) and chloride (111).
History of moderate to heavy social alcohol consumption.
Does not take any regular medication or have history of drug abuse.
Married 25 years with two children and successful career.
Complaints have been treated in past as stress and/or alcohol related.
Would like thoughts on possible causes and course of action.
Dear Steve T,
The most probable explanations are alcohol-related liver disease or fatty liver. You need to be checked for Hepatitis B and C infection, even though you do not provide a history of high risk behaviors, blood transfusions etc. Additionally, you should have blood tests done to exclude autoimmune liver disease and hemochromatosis, a disease in which there is excess iron deposition in the liver.
I suggest that you watch your diet and try to lose weight. Alcohol should be stopped to see if the liver tests improve. The only definitive method to determine your liver problem is by a biopsy. I do not think, however, that a biopsy is needed at this time. I would follow the other steps suggested in this paragraph.
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