Unexplained liver injury: Searching for the cause

Article Figures & Data

TABLE 1

Key results of laboratory tests ordered at initial presentation

Test	Value^a	Reference range
Alkaline phosphatase	749 U/L	38–113
Gamma-glutamyl transferase	1,761 U/L	10–70
Aspartate aminotransferase	44 U/L	14–40
Alanine aminotransferase	49 U/L	10–54
Total bilirubin	1.0 mg/dL	0.2–1.3
Albumin	3.3 g/dL	3.9–4.9
Total protein	5.4 g/dL	6.3–8.0
Creatinine	1.30 mg/dL	0.73–1.22
Estimated glomerular filtration rate	59 mL/min/1.73 m²	> 60

TABLE 2

Results of laboratory tests ordered after initial evaluation

Test	Value^a	Reference range
Alkaline phosphatase	1,620 U/L	38–113
Gamma-glutamyl transferase	1,676 U/L	10–70
Aspartate aminotransferase	205 U/L	14–40
Alanine aminotransferase	222 U/L	10–54
Total bilirubin	8.9 mg/dL	0.2–1.3
Creatinine	1.45 mg/dL	0.73–1.22
Albumin-to-creatinine ratio	29 mg/g	< 30
Carbohydrate antigen 19-9	174 U/mL	< 37
Carcinoembryonic antigen	8.6 ng/mL	< 5

TABLE 3

Results of laboratory workup for autoimmune, metabolic, and infectious causes

Test	Value^a	Reference range
Alpha-1 antitrypsin	210 mg/dL	90–200
Mitochondrial M2 immunoglobulin (Ig) G	3.3 U	≤ 20.0
Anti-gp210 antibody IgG	0.6 U	0–24.9
Anti-sp100 antibody IgG	1.6 U	0–24.9
Actin smooth muscle IgG	3 U	< 20
Antinuclear antibody	Negative
Ferritin	823.0 ng/mL	30.3–565.7
Iron	146 μg/dL	41–186
Total iron-binding capacity	< 201 μg/dL	232–386
Transferrin saturation	72.6%	15%–57%
Total hepatitis B core antibody	Negative
Hemoglobin	15.8 g/dL	13.0–17.0
White blood cell count	8.28 × 10⁹/L	3.70–11.00
Platelet count	333 × 10⁹/L	150–400