Acute Hepatitis B
Acute Hepatitis B
GNUR543
St. John Fisher College
Mr. Wilson is a 47 year old man being evaluated for complaints of fatigue, anorexia and abdominal distention. On examination, it is noted that the skin is jaundiced and the liver enlarged. D.W. denies significant alcohol or drug use. He denies any known exposure to hepatitis and has never been vaccinated for hepatitis. He is taking no medication. Laboratory tests reveal the following and a diagnosis of acute hepatitis B is made:
1. Review and analyze the laboratory data. What diagnosis is supported by these values? Give your rationale.
Mr. Wilson’s lab work is reviewed below: * AST 142 IU/L * AST (Aspartate aminotransferase) is an enzyme and blood sample results can detect if there is liver damage. AST is found in the heart and liver with much lower levels in muscles and kidneys. In a healthy person the AST is between 10-40 IU/L. If the liver is damaged, AST is released into the blood stream (Hepatitis B, 2011). * ALT 120 IU/L * ALT (Alanine aminotransferase), if elevated can also be an indication of liver damage. ALT is an enzyme that is normally in the liver and kidneys. If the individual is healthy, the ALT is low, between 7-56 IU/L. Elevated ALT is an early indicator of liver damage usually elevating prior to a patient becoming jaundice (Hepatitis B, 2011). * GGT 42 IU/L * GGT (Gamma-glutamyl transferase) is an enzyme that is found in the liver but may also be in the spleen, kidneys and pancreas. As with AST/ALT, GGT is elevated when there is liver damage. The normal test range is 0 – 51 IU/L. GGT will be elevated when there is acute damage to the liver (or bile ducts) (Hepatitis B, 2011). * Alk Phos 84 IU/L * Alk Phos (Alkaline Phosphatase or ALP) is an enzyme found in the liver, bone, kidney and GI tract. Normal range for this blood test is 44 – 147 IU/L. Alk Phos, if elevated generally indicates that there is a blockage in the bile
GNUR543
St. John Fisher College
Mr. Wilson is a 47 year old man being evaluated for complaints of fatigue, anorexia and abdominal distention. On examination, it is noted that the skin is jaundiced and the liver enlarged. D.W. denies significant alcohol or drug use. He denies any known exposure to hepatitis and has never been vaccinated for hepatitis. He is taking no medication. Laboratory tests reveal the following and a diagnosis of acute hepatitis B is made:
1. Review and analyze the laboratory data. What diagnosis is supported by these values? Give your rationale.
Mr. Wilson’s lab work is reviewed below: * AST 142 IU/L * AST (Aspartate aminotransferase) is an enzyme and blood sample results can detect if there is liver damage. AST is found in the heart and liver with much lower levels in muscles and kidneys. In a healthy person the AST is between 10-40 IU/L. If the liver is damaged, AST is released into the blood stream (Hepatitis B, 2011). * ALT 120 IU/L * ALT (Alanine aminotransferase), if elevated can also be an indication of liver damage. ALT is an enzyme that is normally in the liver and kidneys. If the individual is healthy, the ALT is low, between 7-56 IU/L. Elevated ALT is an early indicator of liver damage usually elevating prior to a patient becoming jaundice (Hepatitis B, 2011). * GGT 42 IU/L * GGT (Gamma-glutamyl transferase) is an enzyme that is found in the liver but may also be in the spleen, kidneys and pancreas. As with AST/ALT, GGT is elevated when there is liver damage. The normal test range is 0 – 51 IU/L. GGT will be elevated when there is acute damage to the liver (or bile ducts) (Hepatitis B, 2011). * Alk Phos 84 IU/L * Alk Phos (Alkaline Phosphatase or ALP) is an enzyme found in the liver, bone, kidney and GI tract. Normal range for this blood test is 44 – 147 IU/L. Alk Phos, if elevated generally indicates that there is a blockage in the bile
References: Copstead, L.-E. C. (2010). Pathophysiology. St. Louis: Saunders. Hepatitis. (2011, July 6). Retrieved March 26, 2012, from Lab Tests Online: http://labtestsonline.org Hepatitis B. (2011, July 6). Retrieved March 25, 2012, from Lab Tests Online: http://labtestsonline.org Hepatitis B. (2011, September 1). Retrieved March 24, 2012, from Mayo Clinic: http://www.mayoclinic.com/health Kukka, C. M. (2010). Hepatitis B Fact Sheet. HCSP Publications. Lexicomp. (2012). Retrieved February 5, 2012, from Lexicomp: https://online-lexi.com Liver Blood Tests. (2012, March 28). Retrieved March 30, 2012, from e Medicine Health: http://www.emedicinehealth.com/ Lok, A. S. (2011, February 16). Overview of the management of hepatitis B. Retrieved March 24, 2012, from UpToDate: http://www.uptodate.com Lok, A. S., & McMahon, B. J. (2009). Chronic Hepatitis B: Update 2009. Alexandria: American Association for the Study of Liver Diseases. Mani, H., & Kleiner, D. E. (2009, May 1). Liver Biopsy Findings in Chronic Hepatitis B. Retrieved April 1, 2012, from University of Pennsylvania, Department of Medicine: http://webdev.med.upenn.edu