Alcoholic hepatitis laboratory findings

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Shadan Mehraban, M.D.[2]

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.

• 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)
• According to National Institute on Alcohol Abuse and Alcoholism (NIAAA), Alcoholic Hepatitis is diagnosed based on following criteria:^[3]
  • 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

Template:WikiDoc Sources