Gastroenterology
Case 30: A Woman with Abnormal Liver Blood Tests
CASE
A 54‐year‐old woman is referred for investigation of abnormal liver blood tests. The tests were initially performed by the GP prior to the patient being started on statins. A recent cholesterol was elevated at 7.6 mmol/L. The patient has no symptoms other than mild fatigue. She drinks alcohol no more than 2–3 times a month. She has previously had gynaecological interventions following atypical smear tests but has had no admissions to hospital. She takes bendroflumethiazide and fluoxetine on prescription and evening primrose oil. Her mother had thyrotoxicosis and her maternal aunt had diabetes.
On examination she looks well. She weighs 87 kg (BMI 34). She has mild xanthelasmata under both her eyes. Her BP is 120/70 mmHg and there are no signs of chronic liver disease. Abdominal examination is normal.
Blood tests showed:
Hb 13.4 g/dL WCC 6.4 × 109/L Platelets 306 × 109/L PT 12 sec TSH 0.4 Na 138 mmol/L K 3.5 mmol/L Urea 4.3 mmol/L Creatinine 110 µmol/L Albumin 38 g/L Bilirubin 2 µmol/L ALP 275 U/L AST 24 U/L γ‐GT 350 U/L Cholesterol 7.6 mmol/L
Abdominal ultrasound is normal.
QUESTION 1
Your score this session: 0 of 0
The raised gamma glutamyl transferase (γ‐GT) implies: