A patient with a provisional diagnosis of depression was sen

A patient with a provisional diagnosis of depression was sent to the laboratory for a routine workup. The complete blood cell count was unremarkable except for an elevated erythrocyte mean cell volume. Results of urinalysis were unremarkable. The serum chemistry testing revealed slightly increased aspartate aminotransferase, total bilirubin, and high-density lipoprotein levels. All other chemistry results including glucose, urea, creatinine, cholesterol, pH, pCO2, ALT, sodium and potassium, were within the normal reference range. The physician suspects ethanol abuse; however, the patient claims to be a non-consumer. Subsequent testing revealed a serum GGT three times the upper limit of normal. No ethanol was detected in serum. Screening tests for infection form of hepatitis was negative. 1. Are these results consistent with a patient who is consuming hazardous quantities of ethanol? 2. Is further testing needed to rule ethanol abuse in or out? If so, what tests would you recommend?

Solution

Ques-1: 1. Are these results consistent with a patient who is consuming hazardous quantities of ethanol?

Yes, there is a positive correlation between levels of Gamma-Glutamyltransferase (GGT) in serum of severe alcohol abuse people. Therefore, the results are consistent with a patient who is consuming hazardous quantities of ethanol because subsequent testing revealed a serum GGT three times the upper limit of normal with no need of ethanol presence in serum. It can be concluded that \"elevated aspartate aminotransferase, total bilirubin, and high-density lipoprotein levels\" in the above patient so that it is alcoholic fatty liver disease related to both severe intake of alcohol & eating disorders

Ques-2: Other tests required to examine the serum or urine analysis of \"acetaldehyde\" adduct levels that potentially represent markers of alcohol abuse