Clinical Case Study
Word Count: 278
From the Liver Function Tests (LFTs) done on the patient, glucose concentration in the blood had increased abnormally since 5mM is very close to 5.6mM, indicating hyperglycemia. Possible causes of hyperglycemia are pancreatitis, pancreatic cancer, liver cirrhosis, severe illness, and advanced liver disease. (1). In this case, the high glucose level could be due to advanced liver disease, which is a significant cause of hyperglycemia
Furthermore, the LFTs done showed that the concentrations of Gamma-glutamyl (GGT) and ALP produced had increased to 40IU/L. Although it is within the normal reference range, its increase is abnormal possibly due to biliary obstruction and alcohol abuse, and this infers the patient is suffering from liver disease. Moreover, a high concentration of bilirubin can result in jaundice. (2). The patient's bilirubin concentration is at 40 μmol/L rather than the standard 17 μmol/L, indicating jaundice symptoms. Potential causes of bilirubin are pre-hepatic, hepatic, or cholestatic causes. (2).
We can deduce that the patient is suffering from liver cirrhosis after analyzing biochemical test outcomes of glucose, total protein, albumin, and ALT. Liver cirrhosis development is responsible for the unusual test results and signs observed in the patient. The inflammation/scar tissue in the liver accompanies cirrhosis. It causes intrahepatic biliary obstruction (cholestasis) that prevents bile salts excretion making it accumulate and promote ALP release explaining the increased levels of test results. Furthermore, bilirubin excretion through bile accumulates, giving rise to jaundice development reported in this patient's symptoms.
Varma V, Varma M, Varma A, Kumar R, Bharosay A, Vyas S. Serum total sialic acid and highly sensitive C-reactive protein: Prognostic markers for the diabetic nephropathy. Journal of laboratory physicians. 2016 Jan;8(1):25.
Khan RS, Houlihan DD, Newsome PN. Investigation of jaundice. Medicine. 2015 Oct 1;43(10):573-6.
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