Acute Isolated Hyperbilirubinemia as a Presentation of Alcoholic Liver Disease: A Case Report and Literature Review

Isolated hyperbilirubinemia as a manifestation of alcoholic liver disease without significant liver abnormalities is seen very rarely. We report such a case where a patient with chronic alcoholism presented to the ER with acute jaundice with bilirubin of 24.8 mg/dl, predominantly conjugated in nature along with mild elevation of AST (76 IU/L). There were no other abnormalities of the liver function. The patient underwent extensive laboratory and imaging tests that excluded extrahepatic cholestasis, viral and autoimmune hepatitis, ischemic hepatitis, and so forth. Liver biopsy excluded hemochromatosis, dysplasia, or malignancy and other differentials. Bilirubin gradually trended down to 7.3 mg/dl when alcohol consumption was stopped.

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HUBUNGAN KONSUMSI ALKOHOL DENGAN GANGGUAN FUNGSI HATI PADA SUBJEK PRIA DEWASA MUDA DI KELURAHAN TATELI DAN TELING ATAS MANADO

e-CliniC ◽

10.35790/ecl.2.2.2014.5026 ◽

2014 ◽

Vol 2 (2) ◽

Author(s):

Dicky Conreng ◽

B. J. Waleleng ◽

Stella Palar

Keyword(s):

Risk Factor ◽

Liver Disease ◽

Alcohol Consumption ◽

Liver Function ◽

Alcoholic Liver Disease ◽

Impaired Liver Function ◽

The Third ◽

Impaired Liver ◽

Keywords Alcohol ◽

The World

Abstract: Alcohol consumption is the third biggest risk factor as a cause of disease and disability in the world, and is the biggest risk factor in America and second biggest in Europe as the cause of disease and disability. Alcohol is a causalfactorin 60 types of diseases and injuries and a component cause in 200 others. There are many diseases that is caused by alcohol consumption, one of them causes impaired liver function, such as alcoholic liver disease. However according to the theory, not all alcoholics will have an impaired liver function, so this reasearch was done to confirm that theory. Alcoholism will be measured by the AUDIT questionnaire and the impaired liver function will be measured by the increase in the GGT enzyme. Conclusion: Not all chronic alcoholics will have impaired liver function with the same amount of alcohol consumption. Keywords: alcohol, impaired liver function, alcoholic liver disease, AUDIT, GGT. Abstrak: Konsumsi alkohol merupakan faktor risiko terbesar ketiga di dunia sebagai penyebab penyakit dan disabilitas, dan merupakan faktor risiko terbesar pertama di Amerika serta faktor risiko terbesar kedua di Eropa sebagai penyebab penyakit dan disabilitas. Alkohol merupakan faktor penyebab dari sekitar 60 jenis penyakit dan merupakan faktor komponen dari 200 jenis penyakit lainnya. Terdapat berbagai jenis penyakit yang disebabkan oleh konsumsi alkohol, salah satunya adalah gangguan fungsi hati seperti penyakit hati alkoholik (alcoholic liver disease). Namun menurut teori tidak semua peminum alkohol akan mengalami gangguan fungsi hati, sehingga penelitian ini dilakukan untuk memastikan teori tersebut. Gangguan konsumsi alkohol akan diperiksa menggunakan kuesioner AUDIT dan gangguan fungsi hati akan diperiksa melalui peningkatan enzim GGT. Simpulan: Tidak semua peminum alkohol kronik akan mengalami gangguan fungsi hati dengan jumlah konsumsi alkohol yang sama. Kata kunci: alkohol, gangguan fungsi hati, penyakit hati alkoholik, AUDIT, GGT.

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Alcohol consumption patterns in heavy drinkers with and without alcoholic liver disease (ALD)

Gastroenterology ◽

10.1016/s0016-5085(01)80573-4 ◽

2001 ◽

Vol 120 (5) ◽

pp. A117-A117

Author(s):

K DEAR ◽

M BRADLEY ◽

K MCCORMACK ◽

R PECK ◽

D GLEESON

Keyword(s):

Liver Disease ◽

Alcohol Consumption ◽

Alcoholic Liver Disease ◽

Consumption Patterns ◽

Heavy Drinkers

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Urinary ethyl glucuronide testing detects alcohol consumption in alcoholic liver disease patients awaiting liver transplantation

Liver Transplantation ◽

10.1002/lt.21163 ◽

2007 ◽

Vol 13 (5) ◽

pp. 757-761 ◽

Cited By ~ 53

Author(s):

Yesim Erim ◽

Michael Böttcher ◽

Uta Dahmen ◽

Olof Beck ◽

Christoph E. Broelsch ◽

...

Keyword(s):

Liver Transplantation ◽

Liver Disease ◽

Alcohol Consumption ◽

Alcoholic Liver Disease ◽

Ethyl Glucuronide

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Genetic polymorphisms of cytochrome p4502E1 and susceptibility to alcoholic liver disease and hepatocellular carcinoma in a white population: a study and literature review, including meta-analysis

Molecular Pathology ◽

10.1136/mp.53.2.88 ◽

2000 ◽

Vol 53 (2) ◽

pp. 88-93 ◽

Cited By ~ 60

Author(s):

N A C S Wong

Keyword(s):

Hepatocellular Carcinoma ◽

Liver Disease ◽

Literature Review ◽

Genetic Polymorphisms ◽

Alcoholic Liver Disease ◽

Meta Analysis ◽

White Population ◽

Cytochrome P4502e1

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Primary biliary cholangitis‐autoimmune hepatitis overlap syndrome: Case report and literature review

Clinical Case Reports ◽

10.1002/ccr3.3861 ◽

2021 ◽

Author(s):

Chantelli Iamblaudiot Razafindrazoto ◽

Andry Lalaina Rinà Rakotozafindrabe ◽

Nitah Harivony Randriamifidy ◽

Anjaramalala Sitraka Rasolonjatovo ◽

Tovo Harimanana Rabenjanahary ◽

...

Keyword(s):

Case Report ◽

Literature Review ◽

Autoimmune Hepatitis ◽

Overlap Syndrome ◽

Primary Biliary Cholangitis

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Genetic and Epigenetic Modifiers of Alcoholic Liver Disease

International Journal of Molecular Sciences ◽

10.3390/ijms19123857 ◽

2018 ◽

Vol 19 (12) ◽

pp. 3857 ◽

Cited By ~ 20

Author(s):

Marica Meroni ◽

Miriam Longo ◽

Raffaela Rametta ◽

Paola Dongiovanni

Keyword(s):

Liver Disease ◽

Alcohol Consumption ◽

Alcoholic Liver Disease ◽

Complex Disease ◽

Wide Spectrum ◽

Association Studies ◽

Phenotypic Variability ◽

Genome Wide Association Studies ◽

Epigenetic Factors ◽

Excessive Alcohol Consumption

Alcoholic liver disease (ALD), a disorder caused by excessive alcohol consumption is a global health issue. More than two billion people consume alcohol in the world and about 75 million are classified as having alcohol disorders. ALD embraces a wide spectrum of hepatic lesions including steatosis, alcoholic steatohepatitis (ASH), fibrosis, cirrhosis, and hepatocellular carcinoma (HCC). ALD is a complex disease where environmental, genetic, and epigenetic factors contribute to its pathogenesis and progression. The severity of alcohol-induced liver disease depends on the amount, method of usage and duration of alcohol consumption as well as on age, gender, presence of obesity, and genetic susceptibility. Genome-wide association studies and candidate gene studies have identified genetic modifiers of ALD that can be exploited as non-invasive biomarkers, but which do not completely explain the phenotypic variability. Indeed, ALD development and progression is also modulated by epigenetic factors. The premise of this review is to discuss the role of genetic variants and epigenetic modifications, with particular attention being paid to microRNAs, as pathogenic markers, risk predictors, and therapeutic targets in ALD.

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Case 2.3

Mayo Clinic Body MRI Case Review ◽

10.1093/med/9780199915705.003.0034 ◽

2014 ◽

pp. 67-68

Author(s):

Christine U. Lee ◽

James F. Glockner

Keyword(s):

Weight Loss ◽

Liver Disease ◽

Liver Function ◽

Alcoholic Liver Disease ◽

Signal Intensity ◽

Hepatic Parenchyma ◽

Abdominal Ct ◽

Hepatic Lobe ◽

Hepatic Mass ◽

The Right

42-year-old woman with alcoholic liver disease with new pain, weight loss, and elevated liver function levels; abdominal CT showed a suspicious hepatic mass Axial fat-suppressed T2-weighted FSE (Figure 2.3.1) and fat-suppressed 2D SSFP (Figure 2.3.2) images demonstrate a nodular hepatic contour and underlying nodularity of the hepatic parenchyma with signal intensity slightly lower in the right hepatic lobe, as well as ascites. Axial T1-weighted IP and OP 2D SPGR images (...

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High Ascitic Protein and White Blood Cell Count in Uncomplicated Alcoholic Liver Disease: Case Report

Military Medicine ◽

10.1093/milmed/144.8.544 ◽

1979 ◽

Vol 144 (8) ◽

pp. 544-544

Author(s):

Denis J. Frank ◽

Marcos S. Souza Lima ◽

Robert A. Herman ◽

Eugene R. Schiff

Keyword(s):

Case Report ◽

Liver Disease ◽

Blood Cell ◽

Cell Count ◽

White Blood Cell Count ◽

White Blood Cell ◽

Alcoholic Liver Disease ◽

Blood Cell Count ◽

Disease Case

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Liver function tests and fibrosis scores in a rural population in Africa: a cross-sectional study to estimate the burden of disease and associated risk factors

BMJ Open ◽

10.1136/bmjopen-2019-032890 ◽

2020 ◽

Vol 10 (3) ◽

pp. e032890 ◽

Cited By ~ 2

Author(s):

Geraldine O'Hara ◽

Jolynne Mokaya ◽

Jeffrey P Hau ◽

Louise O Downs ◽

Anna L McNaughton ◽

...

Keyword(s):

Liver Disease ◽

Alcohol Consumption ◽

Liver Function ◽

Reference Range ◽

Liver Function Tests ◽

Sub Saharan Africa ◽

Reference Ranges ◽

Cross Sectional ◽

Function Tests ◽

Glutamyl Transferase

ObjectivesLiver disease is a major cause of morbidity and mortality in sub-Saharan Africa, but its prevalence, distribution and aetiology have not been well characterised. We therefore set out to examine liver function tests (LFTs) and liver fibrosis scores in a rural African population.DesignWe undertook a cross-sectional survey of LFTs. We classified abnormal LFTs based on reference ranges set in America and in Africa. We derived fibrosis scores (aspartate aminotransferase (AST) to Platelet Ratio Index (APRI), fibrosis-4, gamma-glutamyl transferase (GGT) to platelet ratio (GPR), red cell distribution width to platelet ratio and S-index). We collected information about alcohol intake, and infection with HIV, hepatitis B virus (HBV) and hepatitis C virus (HCV).SettingWe studied a population cohort in South-Western Uganda.ParticipantsData were available for 8099 adults (median age 30 years; 56% female).ResultsThe prevalence of HBV, HCV and HIV infection was 3%, 0.2% and 8%, respectively. The prevalence of abnormal LFTs was higher based on the American reference range compared with the African reference range (eg, for AST 13% vs 3%, respectively). Elevated AST/ALT ratio was significantly associated with self-reported alcohol consumption (p<0.001), and the overall prevalence of AST/ALT ratio >2 was 11% (suggesting alcoholic hepatitis). The highest prevalence of fibrosis was predicted by the GPR score, with 24% of the population falling above the threshold for fibrosis. There was an association between the presence of HIV or HBV and raised GPR (p=0.005) and S-index (p<0.001). By multivariate analysis, elevated LFTs and fibrosis scores were most consistently associated with older age, male sex, being under-weight, HIV or HBV infection and alcohol consumption.ConclusionsFurther work is required to determine normal reference ranges for LFTs in this setting, to evaluate the specificity and sensitivity of fibrosis scores and to determine the aetiology of liver disease.

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