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Jan 21, 2006

Dear Mrs McGovern

Is it possible people with or close to kirrosis to have normal ALT/AST levels? Except viopsy,is there any strong sign (through bloodwork or other test) that someonehas to check in order to be sure about this?

Thank you again for the prompt and rsponsible replies that you give to this forum

Response from Dr. McGovern

Patients with cirrhosis may have low platelets and low white blood cell counts. In advanced cirrhosis, they may also have elevated total bilirubin and elevated bleeding times (INR).

On examination there can also be other clues. The patient may have spider angiomata on their skin (spiders) or an enlarged spleen.

However, it is also important to point out that patients with cirrhosis can have normal liver function tests (ALT and AST) and have no signs of cirrhosis on exam. The liver biopsy is the only way to rule out this possibility of having cirrhosis.

I hope this is helpful.

Dr. M

is a liver biopsy necessary?

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