A 30-year-old man presents with a 3-week history of fatigue, occasional fever, yellow skin and sclerae, tenderness below the right costal margin, and dark urine. Physical examination reveals jaundice and mild hepatomegaly. Laboratory studies show elevated serum levels of bilirubin, decreased albumin, and prolonged prothrombin time. Serologic tests disclose antibodies to hepatitis C virus. Which of the following tests is the most accurate method for assessing the extent of liver disease in this patient?
Microscopic examination of a liver biopsy is the best method currently available for assessing the extent of liver disease in a patient with viral hepatitis. The major histologic features of acute viral hepatitis are liver cell injury and inflammation. Microscopic examination shows ballooning degeneration of liver cells, intracellular and extracellular bile stasis, acidophilic bodies, and a mononuclear cell infiltrate. Serum alkaline phosphatase and transaminases (choices B and E) are also useful indicators of the severity of liver disease, but do not allow for an assessment of the chronicity or stage of the disease. Serum ammonia (choice C) is used to monitor patients at risk for hepatic encephalopathy and ordinarily reflects end-stage liver disease.Diagnosis: Hepatitis C, acute
Liver biopsy
Serum alkaline phosphatase
Serum ammonia
Serum immunoglobulins
Liver & Biliary Tract