Elevated SGPT Levels: When to Seek Further Testing - Gastroenterology and Hepatology

Elevated S.G.P.T (Serum Glutamic-Pyruvic Trans

Hello Dr.
Lin: I completed my health check-up in July, and my SGPT level was above 139 U/L with a positive occult blood test.
Should I undergo another examination, or is there something specific I should pay attention to? I usually do not drink alcohol or smoke, but sometimes I work until after midnight and go to bed around 2 AM, waking up at 7:30 AM.
I am very concerned about potential liver issues.
If I go for a check-up, should I see a nephrologist? Thank you!

dike, 20~29 year old female. Ask Date: 2005/11/21

Dr. Lin Minghui reply Gastroenterology and Hepatology

Hello,
1.
A GPT value of 139 indicates liver inflammation, and it is important to investigate the causes of liver function abnormalities.
Common causes include viral hepatitis (chronic B and C), alcohol, medications, and fatty liver disease.
It is essential to monitor liver enzymes and, if necessary, arrange for an abdominal ultrasound examination.
2.
A positive fecal occult blood test indicates gastrointestinal damage, and potential causes such as inflammation, ulcers, or tumors may lead to this result.
Follow-up is necessary, and further testing should be arranged if needed.
3.
These issues can be addressed by consulting a gastroenterologist or hepatologist.
Sincerely, Dr.
Lin Ming-Hui, Internal Medicine.

Reply Date: 2005/11/21

More Info

Elevated SGPT (serum glutamic pyruvic transaminase), also known as ALT (alanine aminotransferase), is a common laboratory finding that can indicate liver dysfunction or damage. An SGPT level above the normal range, which typically is around 7 to 56 U/L, can be a cause for concern, especially when it is significantly elevated, as in your case where it is reported at 139 U/L.
Given your history of elevated SGPT and the presence of occult blood in your stool, it is essential to take these findings seriously. While you mentioned that you do not consume alcohol or smoke, which are significant risk factors for liver disease, other factors could contribute to elevated liver enzymes. These include obesity, certain medications, viral infections (such as hepatitis), autoimmune diseases, and metabolic disorders.

Your work schedule, which involves late nights and potentially irregular sleep patterns, can also impact your overall health, including liver function. Chronic sleep deprivation and stress can lead to metabolic disturbances that may affect liver health.
In terms of next steps, it is advisable to seek further testing to determine the underlying cause of your elevated SGPT levels. This may include:
1. Repeat Liver Function Tests: To confirm the elevation and monitor any changes over time.

2. Hepatitis Panel: To rule out viral hepatitis as a cause of liver enzyme elevation.

3. Ultrasound of the Abdomen: To assess liver size, structure, and any potential abnormalities such as fatty liver or cirrhosis.

4. Complete Blood Count (CBC): To check for any signs of infection or other systemic issues.

5. Metabolic Panel: To evaluate other liver enzymes and assess overall metabolic health.

Regarding your question about whether to consult a nephrologist (kidney specialist), it would be more appropriate to see a hepatologist (liver specialist) or a gastroenterologist, as they are more equipped to handle liver-related issues. A nephrologist would be more focused on kidney function and diseases, which may not be directly related to your current concerns.

In addition to seeking medical advice, consider lifestyle modifications that can support liver health:
- Diet: Adopt a balanced diet rich in fruits, vegetables, whole grains, and lean proteins. Avoid processed foods, excessive sugars, and saturated fats.

- Hydration: Ensure you are drinking enough water throughout the day.

- Exercise: Regular physical activity can help maintain a healthy weight and improve liver function.

- Sleep Hygiene: Aim for consistent sleep patterns and adequate rest to support overall health.

In summary, given your elevated SGPT levels and the presence of occult blood, it is crucial to follow up with appropriate testing and consult a specialist who can provide a comprehensive evaluation of your liver health. Early detection and intervention can significantly improve outcomes and help address any potential issues before they progress.

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