Alcoholism
Description | Basic evaluations: Gamma-GT (↑), discordant to AP, GOP, GPT, bilirubin, CHE, PTT, INR, blood count (MCV increased for up to 120 days, according to erythrocyte life span, anemia, leucopenia, thrombopenia), creatinine (↑), triglycerides (↑), HDL-cholesterol (↑). In opposition to alcoholic hepatitis, in which GOT (AST) is markedly increased and GOT/GPT quotient is generally > 2,0, in non-alcoholic steatohepatitis GPT (ALT) is higher than GOT (AST) and the GOT/GPT quotient mostly < 1,0. Examinations for further evaluation: Ethylglucuronid in the urine, in the hair, CDT (carbohydrate deficient transferrin), alcohol in full blood and in urine, osmolality (↑), glucose (↓), gluconeogenesis-suppression caused by alcohol), calcium (↓), magnesium (↓), phosphate (↓), urea (often > 7 mg/dl), homocystein (Sodium fluoride-plasma), CRP-ultrasensitive (↑), immunoglobulines, ANA, AMA, LKM, SLA, smooth-muscle-antibodies (SMA), RF, haptoglobin, reticulocytes, amylase, lipase, pancreas-elastase, oral glucose tolerance test, ferritin, elastase in the stool, procollagen-III-peptide, AFP, folic acid, vitamin B1, -B3 (niacin), -B6, -C, testosterone (↓) | Additional information | Please note: Questionaires have proven to be advantageous in confirming alcohol abuse. Most effective was the CAGE-questionaire ((Buchsbaum et al.: Screening for alcohol abuse using CAGE scores. Ann internal med 115: 774-777, 1991) In addition to this, regular ethylglucuronid evaluations in the urine and in the hair have proven to be an effective screening for hidden alcohol abuse. |
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