A 55 Year Old Man Presented To His GP With

A 55 year old man presented to his GP with visible jaundice. Since recently becoming the owner of a pub, he would drink alcohol regularly, but believed he did not drink excessively or have an alcohol drinking problem. He was in fairly good health, but had noticed some weight loss and the severity of itching had increased over the past year. He had travelled to Africa in the past 6 months, but did not report to be a drug user or have had any blood transfusions. In his previous job, he worked in the NHS for 30 years. The man had some blood taken for biochemical tests.
Serum:
Total Bilirubin Conjugated Bilirubin AST
ALT
ALP
gGT
Total Protein Albumin
Urine Bilirubin
% Carbohydrate Deficient Transferrin (CDT)
Hepatitis B surface antibody (anti-HBs) Hepatitis B Surface antigen (HBsAg)
Patient Results 110 μmol/L 100 μmol/L
70 U/L
100 U/L 350 U/L 100 U/L 58 g/L 30 g/L positive
4%
+ve -ve
Reference range (3-21 μmol/L) (3-21 μmol/L) (10-50 U/L) (3-55 U/L) (80-280 U/L) (<60 U/L)
(62-82 g/L) (35-50 g/L) (negative)
(<2%)
(negative) (negative)