The document presents a case study on a 58-year-old male patient, Rabin Shrestha, with abnormal liver function tests indicating possible alcoholic liver disease. Key findings include elevated levels of total and direct bilirubin, AST, ALT, and GGT, suggesting hepatocellular damage and potential alcohol abuse. The patient’s alkaline phosphatase levels were normal, leading to the conclusion that his liver issues are likely related to chronic alcoholism.

1. • CASE STUDY OF
• LIVER FUNCTION TESTS

2. Normal Ranges of LFT and Interpretation

3. Case Study Of Patient
Name : Rabin Shrestha
Age : 58 years/ male
LIVER FUNCTION TESTS
TESTS Patients value Normal ranges
Total bilirubin : 3.14 0.1-1.2
mg/dl
Direct bilirubin : 2.20 0.1-0.3 mg/dl
SGPT / ALT : 97 7- 50
IU/L
SGOT / AST : 290 10-40 IU/L
Albumin : 3.9 3.4-
5.4 mg/dl
GGT : 647

4. Interpretation of liver function tests
• Types of bilirubin :
• Direct bilirubin also known as
• Conjugated bilirubin.
• Indirect bilirubin also known as
• Unconjugated bilirubin.
• Patient report indicates increased
• Level of both Conjugated and
• Unconjugated bilirubin.

5. AST and ALT levels
• These are the enzymes indicating hepatocellular damage.
• The levels of ALT in serum are elevated in all liver
diseases.
• Very high levels (more than 1000 units) are seen in acute
hepatitis (viral&toxic)
• Elevation of ALT is more in cases of hepatic disease in
compare to AST.
• But AST may be more than ALT in alcoholics liver
disease.
• In patient report we can observe AST level is almost 7
times higher than then
• Upper limit of normal range and ALT level is almost 2
times increased than

6. Gamma Glutamyl Transferase
(GGT)
• GGT is clinically important because of its sensitivity to
detect alcohol abuse.
• Elevated levels of GGT are observed in chronic alcoholism
, pancreatic disease ,
Myocardial infraction , renal failure, chronic obstructive
pulmonary disease.
In patient report we can observe the elevated levels of GGT
8 times increased from
Upper limits .
So, we can interpret that the patient may be alcoholics .

7. Alkaline Phosphatase (ALP)
• Very high levels of ALP are noticed in patients with
cholestasis or hepatic or
• Hepatic carcinoma.
• In parenchyma diseases of liver, mild Elevation of ALP
is noticed .
• Very high levels of ALP (10-12 times of upper limit may
be noticed in extra hepatic obstruction caused by gall
stones .
• High levels of ALP (10- 25 times of Upper limit ) are
seen in bone disease where osteoblastic activity is
enhanced .
• In patients report ALP is within normal range .

8. • Conclusion : In this case we can interpret that
the patient may be alcoholics so, he is
suffering from alcoholic liver disease .
• Mechanism of alcoholics liver diseases:

9. THANK YOU