Liver function test: Difference between revisions
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imported>Howard C. Berkowitz No edit summary |
imported>Howard C. Berkowitz No edit summary |
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| date = April 4, 2006 | | date = April 4, 2006 | ||
| url = http://www2.umdnj.edu/pathpweb/Lectures/Liver%20and%20GB%20Pathology%20-%20Covin%202006.pdf}}</ref> | | url = http://www2.umdnj.edu/pathpweb/Lectures/Liver%20and%20GB%20Pathology%20-%20Covin%202006.pdf}}</ref> | ||
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*Surrogates for hepatic cell breakdown | *Surrogates for hepatic cell breakdown | ||
**Transaminases | **Transaminases | ||
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***[[Globulin]] | ***[[Globulin]] | ||
***[[Albumin-globulin ratio]] | ***[[Albumin-globulin ratio]] | ||
*[[Coagulation factors]] | {{col-break|width=50%}} | ||
**[[Prothrombin]] | *[[Coagulation|Coagulation factors]] | ||
**[[Prothrombin time]] | |||
**[[International normalized ratio]] | **[[International normalized ratio]] | ||
*Tumor markers | *Tumor markers | ||
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**Copper metabolism | **Copper metabolism | ||
***[[Ceruloplasmin]] | ***[[Ceruloplasmin]] | ||
** | **[[Human iron metabolism]] | ||
***serum | ***[[serum iron]] | ||
***[[total iron binding capacity]] (TIBC) % transferrinsaturation | ***[[total iron binding capacity]] (TIBC) % transferrinsaturation | ||
***[[ferritin]] | ***[[ferritin]] | ||
***[[hepcidin]] (experimental) | |||
*Serology | *Serology | ||
**HBsAg | **HBsAg | ||
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**Anti-HBcAg ([[Immunoglobin#immunoglobin G|immunoglobin G (IgG)]]) | **Anti-HBcAg ([[Immunoglobin#immunoglobin G|immunoglobin G (IgG)]]) | ||
**Anti-HBcAg ([[Immunoglobin#immunoglobin M|immunoglobin M (IgM)]]) | **Anti-HBcAg ([[Immunoglobin#immunoglobin M|immunoglobin M (IgM)]]) | ||
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==Imaging== | |||
While liver function tests are usually considered to be biochemical or immunologic, which themselves are increasingly overlapping, imaging provides valuable material as well. Liver scanning after injection of a radioactive tracer has been used for years to localize defects. Newer functional imaging is still experimental but shows promise. | |||
==Causes of elevated test results== | ==Causes of elevated test results== | ||
{| class="wikitable" align="right" | |||
|+ Patterns of abnormalities of liver function tests | |||
! !! Suggested underlying cause | |||
|- | |||
| AST/ALT ratio > 1<ref name="pmid2774372">{{cite journal| author=Van Ness MM, Diehl AM| title=Is liver biopsy useful in the evaluation of patients with chronically elevated liver enzymes? | journal=Ann Intern Med | year= 1989 | volume= 111 | issue= 6 | pages= 473-8 | pmid=2774372 | doi= | pmc= | url=http://annals.org/content/111/6/473.full.pdf+html }} </ref> || [[Alcoholic liver disease]]s | |||
|- | |||
| [[Alkaline phosphatase]] to total [[bilirubin]] ratio <4<ref name="pmid18798336">{{cite journal| author=Korman JD, Volenberg I, Balko J, Webster J, Schiodt FV, Squires RH et al.| title=Screening for Wilson disease in acute liver failure: a comparison of currently available diagnostic tests. | journal=Hepatology | year= 2008 | volume= 48 | issue= 4 | pages= 1167-74 | pmid=18798336 | doi=10.1002/hep.22446 | pmc= | url= }} </ref><br/>AST/ALT ratio > 2.2<ref name="pmid18798336"/> || [[Hepatolenticular degeneration]] (Wilson's Disease) | |||
|} | |||
Increased blood levels of alanine transaminase have been associated with eating fast food twice a day while limiting [[exercise]].<ref name="pmid18276725">{{cite journal |author=Kechagias S, Ernersson A, Dahlqvist O, Lundberg P, Lindström T, Nystrom FH |title=Fast food based hyper-alimentation can induce rapid and profound elevation of serum alanine aminotransferase in healthy subjects |journal=Gut |volume= |issue= |pages= |year=2008 |pmid=18276725 |doi=10.1136/gut.2007.131797}}</ref> The intervention in the trial aimed to "double the regular caloric intake in combination with adoption of a sedentary lifestyle for four weeks."<ref name="pmid18276725"/> | Increased blood levels of alanine transaminase have been associated with eating fast food twice a day while limiting [[exercise]].<ref name="pmid18276725">{{cite journal |author=Kechagias S, Ernersson A, Dahlqvist O, Lundberg P, Lindström T, Nystrom FH |title=Fast food based hyper-alimentation can induce rapid and profound elevation of serum alanine aminotransferase in healthy subjects |journal=Gut |volume= |issue= |pages= |year=2008 |pmid=18276725 |doi=10.1136/gut.2007.131797}}</ref> The intervention in the trial aimed to "double the regular caloric intake in combination with adoption of a sedentary lifestyle for four weeks."<ref name="pmid18276725"/> | ||
==References== | ==References== | ||
{{reflist|2}} | {{reflist|2}} | ||
Latest revision as of 12:58, 31 December 2010
In clinical medicine, liver function tests include tests for:[1]
ImagingWhile liver function tests are usually considered to be biochemical or immunologic, which themselves are increasingly overlapping, imaging provides valuable material as well. Liver scanning after injection of a radioactive tracer has been used for years to localize defects. Newer functional imaging is still experimental but shows promise. Causes of elevated test results
Increased blood levels of alanine transaminase have been associated with eating fast food twice a day while limiting exercise.[6] The intervention in the trial aimed to "double the regular caloric intake in combination with adoption of a sedentary lifestyle for four weeks."[6] References
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