alcohol abuses
Cirrhosis can be caused by alcohol abuses as seen in the patient above. Cirrhosis occurs when scar tissue replaces healthy liver tissue. Therefore diminishing the livers functions to remove waste in the body, making bile that aids in digestion, storing sugar for energy and making new proteins. When a patient has cirrhosis their ALT and AST, ALP, Bilirubin, and there will also be a decrease in blood proteins.
Major symptoms seen in Cirrhosis is ascites and jaundice. Ascites in the accumulation of fluid in the peritoneal cavity. Ascites happens due to several factors, first there is portal hypertension, in the body’s response to obtain homeostasis it releases local vasodilators affecting splanchnic arteries therby a decrease in effective arterial blood flow and arterial pressure, and a progressive vasodilation results in vasoconstrictors to restore base line perfusion pressure. Therefore resulting in sodium and water retention. The other major symptom is jaundice which is yellowing of the skin and the sclera of the eyes. Jaundice is due to hyperbilirubinemia which is an accumulation of bilirubin in the blood. Since the liver is not functioning correctly it can not get rid of waste such as bilirubin thus resulting in jaundice.
Chronic Liver Disease/Cirrhosis. (n.d.). Retrieved from https://www.hopkinsmedicine.org/health/conditions-and-diseases/chronic-liver-disease-cirrhosis.
The lab values that would be elevated include Alkaline Phosphatase (ALP) , Aspartate Aminotransferase (AST), Alanine Aminotransferase (ALT), Bilirubin and Bilirubin Fractions (Chernecky & Berger, 2013). ALT, ALP and AST are enzymes produced by liver. When liver injury occurs, such as in cirrhosis, these enzymes leak into the bloodstream causing elevated levels. Bilirubin is a by-product of red blood cells which are broken down by the liver. Elevated levels of bilirubin due to injury indicate that the liver is not secreting bilirubin leading to back up in the blood and elevation. Some other labs that could be elevated include Carcinoembryonic antigen (CEA), Monocytes, gamma globulins (Van Leeuwen & Bladh, 2016).
Bilirubin is a yellowish pigment and by-product of natural breakdown of red-blood cells. Increase in bilirubin causes jaundice, which is the yellowing of the skin and whites of the eyes (Huether & McCance, 2017). This is caused by the inability of the liver to eliminate the by-product. This patient also has hepatomegaly, which is an enlarged liver. The liver is enlarged due to scarring caused by excessive alcohol consumption. The scarring of the liver decreases its ability to function and thereby increases liver enzymes in blood.
References:
Chen, R.-C., Cai, Y.-J., Wu, J.-M., Wang, X.-D., Song, M., Wang, Y.-Q., … Shi, K. Q. (2017). Usefulness of albumin-bilirubin grade for evaluation of long-term prognosis for hepatitis B-related cirrhosis. Journal Of Viral Hepatitis, 24(3), 238–245. https://doi-org.ezproxy.hsutx.edu:4443/10.1111/jvh.12638
Chernecky, C. C., & Berger, B. J. (2013). Laboratory Tests and Diagnostic Procedures (6th ed.). St Louis: Elsevier Saunders.
(April 2014) Cirrhosis. National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health. Available online at https://www.niddk.nih.gov/health-information/health-topics/liver-disease/cirrhosis/Pages/facts.aspx
Huether, S. E., & McCance, K. L. (2017). Understanding Pathophysiology. St. Louis: Elsevier.
Van Leeuwen, A. M., & Bladh, M. L. (2016). Labaratory and Diagnostic Testing, Practical application at Bedside. Philadelphia: F.A Davis Company.
