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Dr. Andrew Rynne
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Dr. Andrew Rynne

Family Physician

Exp 50 years

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What Causes Liver Enzymes To Increase Suddenly?

i am a resident of internal medicine, we have patient 67yrs old, known DM with complications admitted with SBP his asitic tap was haemorragic but liver enzymes initially were normal, later raised , hepa viral screening negaitive, tumour markers are negagtive,cultures negative,AFB negative..he is on dialysis almost every other day... on USG abd and pelvis no mass? what could be the cause of diagnosis ? what else we can do for him?
Tue, 28 Oct 2014
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Gastroenterologist, Surgical,  's  Response
Hi, How are you? My name is Dr Suresh Raghavaiah. I am a liver transplant surgeon and I hope to help you out today.
I am sorry to hear about all the issues your patient is having and Let me congratulate you on your interest in helping her.
One piece of information you left out is the patients BMI. Going by the clues, your patient seems to be suffering from Fatty liver disease and its complications (I say this because of the DM, which a common complication of obesity , which in turn also causes NASH). NASH is one of the leading causes of non-infectious liver failure in the current age. The sudden "decompensation" is obviously due to the SBP. And the dialysis could be due to hepato-renal syndrome. If you haven't already done so, Please do get a "fibroscan" of the liver to rule out cirrhosis, and an endoscopy to r/o varices. Your patient might also need be worked up for a transplant if his condition does not improve.

Hope this helps and hope your patient gets to feel better.
Have a great day and please do not hesitate to write back for further clarifications.

Dr Suresh Raghavaiah

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What Causes Liver Enzymes To Increase Suddenly?

Hi, How are you? My name is Dr Suresh Raghavaiah. I am a liver transplant surgeon and I hope to help you out today. I am sorry to hear about all the issues your patient is having and Let me congratulate you on your interest in helping her. One piece of information you left out is the patients BMI. Going by the clues, your patient seems to be suffering from Fatty liver disease and its complications (I say this because of the DM, which a common complication of obesity , which in turn also causes NASH). NASH is one of the leading causes of non-infectious liver failure in the current age. The sudden decompensation is obviously due to the SBP. And the dialysis could be due to hepato-renal syndrome. If you haven t already done so, Please do get a fibroscan of the liver to rule out cirrhosis, and an endoscopy to r/o varices. Your patient might also need be worked up for a transplant if his condition does not improve. Hope this helps and hope your patient gets to feel better. Have a great day and please do not hesitate to write back for further clarifications. Dr Suresh Raghavaiah