In this particular patient, his or her stats were the following(please remember I always get permission from the patients.)
Patient believed he ate something bad. Patient presented acute onset of fatigue, nausea, but had no vomiting, diarrhea, abdominal pain, and fever. physical appearance was unremarkable except a look of acute fatigue. BT results showed:
bilirubin, total - 2.0
alkaline phosphatase, S(stands for serum) - 125
AST (SGOT) - 181
ALT (SGPT) - 197
Reference ranges as follows in the BT:
0.0-1.2
39-117
0-40
0-44
Now remember my mother has always emphasized the relative percentage from the baseline. Any person can see that this person's numbers are abnormal.
These blood test names correlate with liver function. These numbers indicate acute liver injury or parenchymal(meaning inside the tissue rather than an obstruction. Thus bilirubin and alkaline phosphatase numbers would be higher if there was an obstruction.) In the liver, these two items will be most likely elevated in the obstruction setting.
US(ultrasound) confirmed no obstruction. Remember, I said relative, 2.0 to 1.2 and 125 to 117 is not that high.
Doctor started patient on an antibiotic for presumed bacterial gastroenteritis. After 1 tablet, the patient significantly improved. He or she felt much better.
Conclusion? It could have been some acute food poisoning that affected his liver. The reason this is interesting is that most food poisonings do not affect the liver(particularly the liver enzymes.) Sometimes that is the problem with medicine, you might never know the problem but as long as the patient gets better, the end result is fine. Doctors need to be humble that they sometimes .cannot figure out everything - you just need to accept the result. Just be happy that the patient feels better.(It still bothers my mother as to what it was but she just golfs it off.)
