Will raised SGOP and SGPT cause itching, drowsiness, and tiredness in me?

Hi,

Welcome to icliniq.com.

I understand your concern.

You seem to have three sets of clinical evidence.

1. Liver function tests- elevated SGOT (serum glutamic-oxaloacetic transaminase) and SGPT (serum glutamic pyruvic transaminase). Do you have any changes in the color of urine, stools, eyes, and symptoms like nausea and loss of appetite, which may suggest jaundice?

2. Hematological evidence like neutropenia and lymphocytosis suggests a subchronic and viral infection. Did you have any symptoms such as fever, throat soreness, or loose motions?

3. Thrombotic evidence shows your platelet width; platelet- large cell ratio increases, leading to thrombotic phenomena. Kindly undertake a lipid function test (blood test to detect abnormal blood lipids) to corroborate the above interpretation.

4. Dermatological evidence, itching. Please upload any photographs of the skin lesions.

It is best to take the following investigations.

A. Blood tests.

1. Lipid function tests (LDL (low-density lipoprotein), VLDL (very low-density lipoprotein), TC (total cholesterol), HDL (high-density lipoprotein), TG (triglycerides), apolipoprotein A and B).

2. INR (international normalized ratio).

3. PT (prothrombin time), aPTT (activated partial thromboplastin time).

B. Allergen test package.

I suggest,

1. Tablet Aspirin 75 mg, one tablet for 15 days.

2. Tablet Montelukast 10 mg, Levocetirizine 5 mg tablet once daily for 15 days.

Please revert with test reports at the earliest.

Kind regards.

Hi,

Welcome back to icliniq.com.

The cause of raised SGOT and SGPT still needs to be investigated. Do you consume alcohol? If so, I will request you abstain from consuming for some time.

I also suggest the following investigations.

1. USG (ultrasonography) abdomen and pelvis.

2. Blood- INR, PT, APTT, lipid function tests, liver function tests (repeat after a month from the last test).

3. Allergen test package.

4. ECG (electrocardiography) and 2D (2 dimensional) echocardiography.

Continue the medications prescribed earlier.

Kind regards.

Hi,

Welcome back to icliniq.com.

Your current reports indicate prolonged APTT but normal PT. There are multiple clinical potential reasons for such findings.

1) Inherited cause.

a) Deficiency of factor VIII, IX, or XI.

b) Deficiency of factor XII, pre kallikrein, or HMW (high molecular weight) kininogen (not associated with a bleeding diathesis).

c) Von Willebrand disease (variable).

2) Acquired cause.

a) Treatment with Heparin, Dabigatran, Argatroban, direct factor X inhibitors (variable).

b) Acquired factor VIII inhibitor (antihemophilic factor), IX (christmas factor), XI (Hageman factor), or XII (fibrin stabilizing factor).

c) Acquired Von Willebrand syndrome.

d) Lupus anticoagulant.

Have you been treated with any of the medicines mentioned above or diagnosed with any of the diseases mentioned above at any time? Please do not take Aspirin, as mentioned earlier. Please continue with Tablet Montelukast 10 mg and Levocetirizine 5 mg tablet once daily for 15 days.

Your liver functions, including SGOT, and SGPT, are elevated. SGOT and SGPT ratio is greater than 2 (as in your case). This occurs predominantly (70 %) in alcoholic hepatitis and cirrhosis, compared with 26 % of patients with post-necrotic cirrhosis, 8 % with chronic hepatitis, and 4 % with viral hepatitis. Based on the above, please let me know the following.

Did you ever get viral hepatitis (hepatitis A, B, C, D, E) or infective (non-obstructive) jaundice in the past? Repeating the question of whether you had a continued alcohol intake in the past and that may have been discontinued now?

Also, kindly undertake the other tests mentioned earlier, including.

a) USG abdomen and pelvis.

b) Allergen test package.

c) ECG and 2D echocardiography.

Kind regards.

Hi,

Welcome back to icliniq.com.

Kindly complete the recommended tests, and please revert to the reports.

Thank you.

Hi,

Welcome back to icliniq.com.

The USG report (the attachments are removed to protect the patient's identity) shows no abnormality. This rules out any liver or other organ damage within the abdomen and pelvis. Let us now get the allergen tests and ECG and 2D echocardiography reports.

Thank you.