Viral Hepatitis and Liver Disease Website Course

Evaluating Liver Test Abnormalities

Understanding the Pathophysiology of Liver Disease

for Health Care Providers

Alcoholic Liver Disease - Alcoholic Liver Disease

Back to Chronic Hepatocellular Injury

The diagnosis of alcoholic liver disease can be difficult since patients may minimize the amount of alcohol use. The physical examinations may be non-revealing unless advanced disease is present.

The diagnosis is supported by:

  • AST:ALT ratio of 2 or greater**
  • Elevated gamma-glutamyl transferase
  • Elevated MCV

** In most other causes of chronic hepatocellular injury, ALT level is generally greater than ALT. AST may also be greater than ALT in patients with cirrhosis of any etiology.

In addition to laboratory investigations directed at determining a possible etiology of chronic hepatocellular injury, platelets, albumin and prothrombin time/INR should be obtained. The presence of the following is suggestive of cirrhosis:

  • Thrombocytopenia, hypoalbuminemia or prolonged prothrombin time/INR