From the Guidelines
The patient's laboratory values indicate abnormal liver function tests, suggesting liver inflammation or injury, and I strongly recommend prompt medical evaluation by a healthcare provider for further assessment, including additional liver function tests, hepatitis screening, and imaging studies like ultrasound or CT scan of the liver. The total bilirubin of 1.1 mg/dL is slightly elevated, AST of 169 U/L is significantly elevated, and alkaline phosphatase of 347 U/L is also elevated, which are indicative of liver damage or disease, as noted in the study by 1.
The elevated AST and alkaline phosphatase levels suggest hepatocellular injury and cholestasis, respectively, which can be caused by various conditions, including viral hepatitis, medication effects, autoimmune disorders, or biliary obstruction, as discussed in the study by 1. The severity of abnormal aminotransferase can be classified as mild, moderate, or severe, and in this case, the AST level is significantly elevated, indicating a moderate to severe abnormality, as classified in the study by 1.
The patient should avoid alcohol and medications that can stress the liver, such as acetaminophen/Tylenol, and stay well-hydrated while waiting for their appointment, as recommended in the study by 1. It is essential to report any symptoms like jaundice, abdominal pain, dark urine, or light-colored stools to the doctor immediately. Proper diagnosis is crucial before specific treatment can be recommended, and the patient should undergo further evaluation, including additional liver function tests, hepatitis screening, and imaging studies, to determine the underlying cause of the abnormal liver function tests.
From the Research
Laboratory Results
- Total Bilirubin: not provided
- AST (Aspartate Aminotransferase): 1.1 times the upper limit of normal, but the exact value is 169, and the upper limit of normal is not provided
- Alkaline Phosphate: 347, but the upper limit of normal is not provided
Interpretation of Results
The provided laboratory results show elevated levels of AST and Alkaline Phosphate. According to 2, elevated liver enzymes can be a normal physiological phenomenon or reflect potential liver injury. The study suggests a step-wise algorithm for interpreting abnormal elevation of liver enzymes in asymptomatic patients.
Possible Causes and Next Steps
- The pattern of enzyme alteration can help identify the cause of elevated liver enzymes. As stated in 3, evaluation should be guided by both the clinical presentation and the pattern of injury.
- The exact cause of the elevated AST and Alkaline Phosphate levels cannot be determined without further information about the patient's medical history, symptoms, and other laboratory results.
- Studies such as 4, 5, and 6 discuss the use of ursodeoxycholic acid in the treatment of various liver diseases, including autoimmune hepatitis and acute viral hepatitis. However, these studies do not provide direct guidance on the interpretation of the provided laboratory results.
Further Evaluation
Further evaluation and investigation are necessary to determine the cause of the elevated liver enzymes and to guide management. This may include additional laboratory tests, imaging studies, and a thorough medical history and physical examination, as suggested in 2 and 3.