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What Does My Lab Test Report Indicate?

Posted on Tue, 1 Sep 2015

Question: Hello,

In February 2012 I had a ct scan of my abdomen and they said I had fatty liver...11 months ago I had an ultrasound on my liver and they said I still had fatty liver...I just had a blood test, ast level was 27, alt was 45, and platelets was 179...could I have cirrhosis?

I am a 29 year old male no symptoms...I am just concerned because the alt seems high and the platelet level seems low, and I have had fatty liver for a while...I've never been a big drinker, but I am moderately overweight...could it have progressed to cirrhosis since my ultrasound 11 months ago?

Answered by Dr. Shailja Puri (17 minutes later)

Brief Answer:
Fatty liver is reversible,development into cirrhosis not likely.

Detailed Answer:
Hello,
Thanks for posting your query on HealthcareMagic.

Fatty liver is caused by various factors and alcoholism is the most common one.
Other causes of fatty liver include obesity, diabetes mellitus, starvation and under-nourishment.
Fatty liver is a reversible condition and can get reversed if the risk factor is removed.
As you have mentioned that you are overweight, it may be the cause of fatty liver.
If you have other risk factors like diabetes mellitus, it may be the cause too.
Consumption of alcohol should be stopped even if taken in small quantities.
Development of fatty liver to cirrhosis is a long process and it takes several years to develop if the causative factor still persists.
Since, you are still having fatty liver, removal of risk factor will reverse the process and the liver will be normal.
AST level of 27 and ALT level of 45 is within normal range, although ALT is slightly high.
Correction of weight will help.

Thanks and take care
Dr Shailja Puri

Above answer was peer-reviewed by : Dr. Vinay Bhardwaj

Follow up: Dr. Shailja Puri (10 minutes later)

Is the alt of 45 with a platelet level of 179 a concern?

How many years of fatty liver would it take to get to cirrhosis? I had an ultrasound on my liver 11 months ago, and have had fatty liver for a while, is it possible that it could have developed since 11 months ago?

Answered by Dr. Shailja Puri (12 minutes later)

Brief Answer:
Platelet count of 179 is normal, ALT is slightly raised due to fatty liver

Detailed Answer:
Hello and welcome again,
Platelet count of 179 is within normal range.
The lower limit for platelets is 150.
ALT is slightly raised and this could be due to fatty liver.
Regular follow up to monitor its level may be done.
11 months is a very short period for the development of cirrhosis.
Consult your doctor to figure out the cause of fatty liver.
Removal of the cause of fatty liver will reverse the condition.

Thanks and take care
Dr Shailja Puri

Above answer was peer-reviewed by : Dr. Vinay Bhardwaj

Follow up: Dr. Shailja Puri (16 minutes later)

I understand what you are saying...I am trying to find out if the progression toward cirrhosis is something that would have been seen on a ultrasound...I know the ultrasound showed fatty liver, but would a fatty liver heading toward cirrhosis been noticed on the exam, or does fatty liver look similar on an ultrasound regardless of how mild or progressed it is?

Answered by Dr. Shailja Puri (2 hours later)

Brief Answer:
Fatty liver and cirrhosis liver are distinct on ultrasound.

Detailed Answer:
Hello and welcome again,

The ultrasound findings of fatty liver are distinct from that of cirrhosis liver.
Cirrhosis liver can be picked up on ultrasound and further evaluated on fibroscan.

Thanks and take care
Dr Shailja Puri

Above answer was peer-reviewed by : Dr. Vinay Bhardwaj

Follow up: Dr. Shailja Puri (7 hours later)

I understand that...but my question is, would the ultrasound have shown if the fatty liver was so bad that it was headed toward cirrhosis? Can an ultrasound tell the difference between mild fatty liver and severe fatty liver?

Answered by Dr. Shailja Puri (5 hours later)

Brief Answer:
Ultrasound can differentiate between mild & severe fatty liver

Detailed Answer:
Hello and welcome again,
The ultrasound can differentiate between mild and severe fatty liver.
Fatty liver does not directly progress to cirrhosis.
Fatty liver first progresses to hepatitis and then to cirrhosis.
Hepatitis is accompanied by derangement of various liver enzymes.
Thus, monitoring of liver enzymes will help to monitor the liver functions.

Thanks and take care
Dr Shailja Puri

Above answer was peer-reviewed by : Dr. Raju A.T

Follow up: Dr. Shailja Puri (2 hours later)

Thank you...I paid again so I could ask a follow up...does my ast of 27 rule out cirrhosis? I read that ast is usually higher than alt in cirrhosis

Answered by Dr. Shailja Puri (6 hours later)

Brief Answer:
AST of 27 is within normal range

Detailed Answer:
Hello and welcome again,
AST level of 27 is within normal range.
Cirrhosis is a late stage and it is preceded by hepatitis.
Hepatitis is characterized by high liver enzymes like AST and ALT.
Cirrhosis follows hepatitis.
Since, you are concerned about cirrhosis, I suggest you o get a fibroscan.
Fibroscan particularly done for fibrosis in liver and thus cirrhosis.
You need to consult your gastroenterologist for the investigation.

Thanks and take care
Dr Shailja Puri

Note: Do you have more questions on diagnosis or treatment of blood disorders? Ask An Expert/ Specialist Now

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar