[Ming Pao News]Ms. Wang (pseudonym), a middle-aged woman, inquired about information about colonoscopy because she has a family history of colorectal cancer. However, I read her recent physical examination report and found that her liver enzymes were elevated and her liver function may be damaged, so I suggested that she undergo a liver test first.[Editor’s note: The examination showed that Ms. Wang did not suffer from viral hepatitis or obvious fatty liver. The ultrasound report showed that she only had one tiny gallstone, but it was not the cause of the increase in liver enzymes. So a second round of blood tests was performed, and the results showed that it was possible. Suffering from primary biliary cholangitis. ]
Increased liver enzymes, cholangitis, hepatitis, and fatty liver symptoms may not be obvious
Chronic liver disease may not have obvious symptoms such as abdominal pain and fever. Patients may only feel tired and have a loss of appetite. Therefore, many patients only discover that they have liver disease during a physical examination or blood draws for other reasons. However, the seriousness of liver disease cannot be ignored. If patients lack appropriate treatment and follow-up, it may lead to cirrhosis and liver failure. Therefore, it is necessary to find out the cause and prescribe the right medicine.
During the diagnosis process, various common culprits of liver diseases should be ruled out, including chronic hepatitis B, fatty liver, liver damage caused by drugs or alcohol abuse, etc. Bile duct and gallbladder diseases should also be ruled out. I arranged blood tests, liver and gallbladder ultrasound and liver fibrosis scans for Ms. Wang.
Surprisingly, the examination report showed that Ms. Wang did not suffer from viral hepatitis or obvious fatty liver, nor did she take high-risk drugs or drink alcohol. The ultrasound report showed that she only had one tiny gallstone, which could not explain the increase in liver enzymes. situation. So I did a second round of blood tests for Ms. Wang, and it was found that she had some relatively rare antibodies, indicating that she might be suffering from primary biliary cholangitis.
Related reading: Physical examination deconstruction (medium) liver function index
Patients with chronic liver disease may not have obvious symptoms such as abdominal pain and fever. They may only feel tired and have a loss of appetite. (The design pictures and models have nothing to do with the cases mentioned in the article, miya227@iStockphoto)
Related reading: There are ways to reverse fatty liver (Yanghe Medical Encyclopedia)
Cholangitis: Bile accumulation in the liver causes fibrosis or is related to the immune system
Primary biliary cholangitis is uncommon and most patients are women. When the patient’s bile duct is damaged, bile accumulates in the liver, leading to impaired liver function and liver fibrosis. The cause of the disease remains unknown, but may be related to immune system problems.
Finally, Ms. Wang took ursodeoxycholic acid, a drug targeting the disease. During her follow-up visit two months later, her liver function had improved significantly.
Text: Yu Tingfeng (Associate Consultant (Endoscopy), Gastroenterology and Hepatology Specialist, Tung Wah Group of Hospitals)
(Medical Man Donghua)
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2024-03-13 07:50:17
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