Alcoholic Liver Disease (ALD)

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).

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.

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