Liver function Tests

Posted by e-Medical PPT
Liver dysfunction diagnosis
The diagnosis of liver disease depends on a combination of patient history, physical examination, laboratory testing, biopsy and sometimes imaging studies such as ultrasound scans.

Liver function Test
Enzyme tests
    –Alkaline phosphatase
    –Gamma glutamyl transpeptidase
• Tests of synthetic function
    – Prothrombin time
• Tests of hepatic transport capability
    –Serum bilirubin

Total protein
There are 2 major types of protein: albumin and globulin.
Normal range 5.6 -8.4 g/dl
Albumin (ALB) Albumin provides a gauge of nutritional status. It can be reduced due to liver damage and kidney disease. Because albumin is made in the liver, levels tend to drop with cirrhosis.
High albumin levels usually reflect dehydration and use of some drugs
reference values are dependent on many factors, including patient age, gender, sample population, and test method,
Normal range 3.4 -5.4 g%
The microalbumin test measures very small levels of albumin in your urine and may indicate whether you are at risk for developing kidney disease

Globulin This describes the specific level of globulins — which include antibodies. This measure can be raised when liver cells are damaged due to autoimmune liver damage or to long-standing liver disease of many types, particularly when cirrhosis exists, multiple myeloma and chronic infections.

Bilirubin Bilirubin is a by-product of the breakdown of red blood cells. It is the yellowish pigment responsible for jaundice.
Bilirubin levels can be raised due to many different liver diseases, as well as conditions other than liver disease, e.g. gallstones. In cases of long-term liver illness (chronic hepatitis).
In cases of short-term liver illness (acute hepatitis), elevated bilirubin levels indicate the severity of the acute illness.
Normal range 0.2 -1.5 mg/dl

Alanine transaminase (ALT(
also called Serum Glutamic Pyruvic Transaminase  (SGPT) or Alanine aminotransferase (ALAT)
Enzyme produced and present in hepatocytes (liver cells).
ALT rises dramatically in acute liver damage, such as all types of hepatitis (viral, alcoholic, drug-induced etc) or paracetamol (acetaminophen) overdose.
The reference range is 15-45 U/L in most laboratories. Levels of ALT may equate to the degree of cell damage but this is not always the case, particularly with hepatitis C. An accurate estimate of liver cell damage can only be made by liver biopsy.

Aspartate transaminase (AST(
also called Serum Glutamic Oxaloacetic Transaminase (SGOT) or aspartate aminotransferase (ASAT)
Similar to ALT in that it is another enzyme associated with liver parenchymal cells. It is raised in acute liver damage, but is also present in red cells, and cardiac and skeletal muscle and is therefore not specific to the liver.
It does tend to be higher than ALT in cases of alcohol-related liver disease.

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