From the archive
Hb = 48 g/L, that is severe life threatening anaemia.
WCC =14.9 X10^9/L, that is high – stress response.
Urea = 40.5 mmol/L, that is significantly elevated. While the creatinine is within normal range.
Elevated ALP (200 U/L, Mild) and GGT (178 U/L), together with low albumin and total protein suggest chronic liver disease or chronic alcohol abuse. Normal ALT may indicate chronic liver disease and cirrhosis (although Bilirubin normal)
Causes of ALP elevation (Marked elevation is when the level more than 4 times the normal level):
- Extra-hepatic biliary obstruction
- High bone turn over
Severe anaemia with significantly elevated Urea suggest severe life threatening upper GI bleed requiring resuscitation and early referral to gastroenterology.
- Oesophageal varices
- Duodenal Ulcers
- Gastric erosions
- Gastric Ulcers
- Mallory-Weiss tears
Glassgow Blatchford score
- Male sex
- SBP < 100 mmHg
- HR > 100/min
- Urea > 6.5
- History of liver disease