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Indication of ursodeoxycholic acid

Dear team,

Is ursodeoxycholic acid prescribed in CF even if the liver value SGGT is always very good (9), while other liver values are slightly higher than usual since months?

SGOT 41 (-35 norm), SGPT 48 (-45 norm), ALKP 140 (53 – 128 norm according to laboratory).

Apart from that my liver is without pathological findings and disturbances.

Many thanks in advance
S. Gayer

You ask if the treatment with ursodeoxycholic acid in CF patients is justified if the liver values (SGOT and SGPT) are slightly increased but the Gamma-GT is normal.

Generally speaking there are no absolute and commonly accepted criteria demanding the necessity of a therapy with ursodeoxycholic acid. Particularly, there are no clear rules stating for which constellation of laboratory values such a therapy should not or must not be administered. The liver values in CF patients are quite variable and can be normal today, but considerably higher than e.g. in your case two weeks later.

Therefore, one should also consider additional findings like e.g. the ultrasound findings of the liver. If these show findings consistent with liver fibrosis, there is certainly an indication for an ursodeoxycholic acid therapy. An increased SGGT is not an obligation. Since ursodeoxycholic acid is very well tolerated and almost does not have any side effects it should be used generously in case of doubt because it offers a protective function for the liver.

Best regards,

Dr. H.-G. Posselt