At a Glance

No biochemical markers pathognomonic for alcoholic liver disease (ALD) exist. The diagnosis has to start with evidence of alcohol abuse either from a history of documented blood alcohol levels or from response to one of the questionnaires desired to elicit a history of ongoing alcohol abuse.

What Tests Should I Request to Confirm My Clinical Dx? In addition, what follow-up tests might be useful?

Historically, gamma glutamyl transpeptidase (GGT) has been used as a screening tool for alcoholism.

Another, relatively specific marker for ALD is carbohydrate deficient transferrin (CDT).

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Elevations of aspartate aminotransferase up to six times the upper limit of normal and alanine aminotransferase up to 5 times its upper limit of normal is consistent with alcohol abuse, especially with a ratio greater than 2:1. A ratio of 3:1 has a sensitivity of 90% for the diagnosis.