<s>[INST] my patient who was 2 years old. He eats so much and has hepatomegaly. No splenomegaly. Serum sugar, ferrum, CPK were normal while ASAT, ALAT increased. Abdominal CT: Hepatomegaly. We are suspecting metabolic disorder? but i could not define exactly what illness. what do you think? [/INST] Hi thanks for asking question. Noted this 2 year child having elevated liver enzymes and hepatomegaly.... Here yes chances of metabolic disorder is present....like that if glycogen storage disorder or tyrosine.... Detailed investigation and complete history taken ....If you need liver biopsy might be needed...for his to pathological examination..... Niman pick disease or Wilson disease also congenital causes.... And yes finally congenital hemolytic anemia also has to be ruled out....If you need electrophoresis might be done from blood sample to rule out sickle cell or that. Hope your concern solved... </s>