Exam question.

[Abid97]

39-year-old woman attended her GP complaining of upper abdominal pain. When questioned about the history of the pain, she explained that it became worse after meals and it had been persistent for some time. When asked for any other unusual symptoms, recent weight loss was noted and she explained that she had been experiencing unusually greasy stools, even though she had not changed her diet. When the GP looked further back into the patient’s records, he noted a history of alcohol abuse. Upon questioning, the patient admitted that although she had reduced her intake, she was still having a ‘glass or two’ of wine every evening.

The GP requested non-fasting bloods to be sent to the laboratory and results were as follows:

 

Analyte	Result	Reference Range	Units
Alkaline Phosphatase (ALP)	126	40 - 125	IU/L
Alanine Aminotransferase (ALT)	36	10 - 40	IU/L
Albumin	34	36-37	g/L
Glucose	13.1	<11.1	mmol/L
Amylase	96	<100	U/L
Faecal Elastase	62	>200	µg/g *Can anyone diqgnose her as it for an exam question case study i need to do thanks.

[hypervalent_iodine]

Could you show your attempts at solving the question? 

[Abid97]

I believe this patient have pancreatitis. Firstly because high levels of ALP, which is an enzyme in the blood that help breakdown protein and other functions such as metabolism in the liver. High levels indicate issue with liver, pancreas. Unlikely to be liver due to no symptoms real symptoms related eg: jaundice, fatigue except for abdominal pain. But anyway. Also high levels of glucose within blood suggesting that diabetic but no mention of that. Maybe hyperglycemic. Or high levels due to infection present.

 

Amalayse/ faecal elastases gave me a good idea that the issue is to do with the pancreas. Since amalyse is a pancreatic enzyme. High levels indicate infection, leads to cholecytitis. Also another symptom is abdominal pain. Feacal elasatses anotger enzyme linked to pancrease more specifically, exocrine tissue of pancrease. Responsibile for enzyme production which r responsible fir breakdown if carbs, fats protiens etc. Another symptoms greasy stool which backs this idea up of pancreatitis. Also weight loss another symptom. This may also be causing diabities which cause s high level glucose present in blood.

 

So all in all im thinking this patiwnt has pabcreatitis leading to cause maybe diabities. Also leading to malabsorption. Increase effect due to her history of alcoholism and poor diet. 

 

Let me know if its pancreatitis. Would like to know if missing something or wrong. Or if i can be more accurate in diagonsing if its acute or chronic. Or if its causing diabities also. 

* Sorry for bad spelling. 

 

 

[Bufofrog]

I simply entered "low faecal elastase slightly elevated glucose" into google and got some pretty clear results...