Which laboratory pattern is most suggestive of alcoholic hepatitis rather than simple fatty liver?

• A. Complete absence of any transaminase elevation with normal inflammatory markers always indicates alcoholic hepatitis.
• B. Isolated elevated pancreatic enzymes with no transaminase changes are pathognomonic for alcoholic hepatitis rather than fatty change.
• C. Persistent severe hypoglycemia and extremely high creatinine are the sole indicators that distinguish alcoholic hepatitis from fatty change.
• D. Moderate elevations in AST and ALT with AST often greater than ALT (AST:ALT ratio >2), elevated inflammatory markers, and possible modest bilirubin increase consistent with hepatocellular inflammation.

Answer: (D)