Case help please.

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Ammie

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Hey,
I am trying to get aorund the following questions but cannot manage much. I am finding it strange that the ALT has remained normal and cannot get around what that might mean. Maybe some form of Hepatorenal syndrome? but than amylase is high too.
Any help would be appreciated.

Case:

A 55 year old male with a history of depressive illness develops anorexia and abdominal pain. The family doctor notes jaundice and a moderate hepatomegaly. The patient has a papular itchy rash on his antecubital fossa.

Investigations:

Serum analytes Measured value Reference Range
Cholesterol 30.8mm/L up to 5
Triglycerides 131mmol/L up to 1.8
Bilirubin 58mcmol/L up to 17
Alkaline phosphatase 282IU/L up to 108
ALT 22IU/L up to 40
GGT 1285IU/L up to 45
Amylase 1050IU/L up to 100

Questions
1. How do you interpret these findings?
2. Which of these findings explain his rash?
3. How would you investigate the lipid abnormalities further?
 
This is not the place for homework help. Head to your local medical library and consult the reference books there.
 
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