How can I help with alcoholic liver disease treatment?

Question

Hello doctor,

My female friend, who is 60 years old, has been diagnosed with possible cirrhosis. She presents with mild palmar erythema, itching, RUQ pain, and neuropathy. Her history includes hyperlipidemia, two breast cancer episodes treated with CMF, Adriamycin, Tamoxifen, and right-sided radiation.

Social drinking averages two drinks per week (range: 0–6), confirmed by family. Computed tomography and sonography show mild fatty liver, MRI, and MRE are normal, and labs (CBC, CMP, ALT) are within normal limits.

Other cirrhosis etiologies (for example, hepatitis and alpha-1 antitrypsin deficiency) are ruled out. She is hesitant about a biopsy, citing risks, the stigma of ALD diagnosis, and its impact on treatment. How would you report biopsy findings if consistent with alcohol-related liver disease?

Kindly help.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

I can understand your concern.

In cirrhosis, the liver's function is affected, leading to lower serum protein levels, particularly albumin. You can investigate this further through protein estimation.

Since the sonography does not show liver nodules, the likelihood of cirrhosis seems reduced. If a biopsy is considered, it can confirm cirrhosis, but the decision should be based on your clinical examination.

Meanwhile, a complete liver profile should be done, including serum protein, albumin, bilirubin, serum glutamate-pyruvate transaminase (SGPT), and serum glutamate-oxaloacetate transaminase (SGOT).

Steatohepatitis could also cause similar symptoms. It’s advisable to consult a physician or gastroenterologist for further evaluation and management.

I would be happy to help you if you have any questions.

Thank you.