Investigations
It is essential to take an accurate history of alcohol intake.
- FBC: may reveal macrocytosis
- LFTs:
- a raised gamma GT indicates possible alcohol abuse
- abnormal ALT reflects hepatocellular damage
- an AST:ALT ratio that is greater than 2 suggests alcoholic damage
- there may be an elevated serum IgA; anti-smooth muscle antibodies may be found
- liver biopsy: reveals extent of liver damage and suggests prognosis
Investigations not specific for liver disease:
- serum carbohydrate-deficient transferrin: this is a sensitive test for alcoholism, but does not reveal the presence or absence of liver disease
- blood alcohol
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