Important symptom of underlying hepatic disease

Fatigue is often an important symptom of underlying hepatic disease. Intense pruritus and other dermatologic changes in the presence of elevated bilirubin and alkaline phosphatase suggest cholestasis. Transaminase elevations generally signify hepatocellular inflammation or necrosis. Hepatomegaly and elevated alkaline phosphatase may be the only signs of infiltrative disease and mass lesions. Bilirubin exceeding 10mg/dL is more often associated with carcinoma than with cholecystitis or stones.