A 54 -year-old executive reported with vague complaints of fatigue and some alterations in mental status, such as forgetting appointments. He recalled that the problems had arisen after his visit to abroad few months back on a business meeting. He also complained of some loss of appetite and vague pain especially towards the right side of abdomen.
General physical examination revealed a borderline enlargement of the liver. Important laboratory findings were as listed below:
Serum AST = 320 IU/L – (Normal 0-41 IU/L)
Serum ALT = 120 IU/L – (Normal 0-45 U/L)
Serum ALP = 78 IU/L (Normal 30-115 IU/L)
Serum GGT = 170U/L (Normal 6-37 U/L)
Serum total Bilirubin =-1.1mg/d L (Normal -0.2-1.2mg/dL)
Blood glucose = 58 mg/dL (Normal 60-100 mg/dL)
Serum uric acid = 10.8 mg/dL (Normal 3.0-9mg/dL)
CBC and urinalysis results were normal.
What is the probable diagnosis?
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