Liver function tests: Difference between revisions

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==Aminotransferases (ALT/AST)==
==Aminotransferases (ALT/AST)==
*Elevation is associated with liver damage
*Elevation is associated with liver damage
*Elevations in AST >> ALT suggest liver damage from alcoholism (i.e. alcoholic hepatitis)
*Elevations in AST >> ALT suggest liver damage from alcoholism (i.e. [[alcoholic hepatitis]])
*Elevations in ALT >> AST suggest liver damage from another etiology (i.e. infectious hepatitis)
*Elevations in ALT >> AST suggest liver damage from another etiology (i.e. infectious [[hepatitis]])


==Alkaline Phosphatase==
==Alkaline Phosphatase==
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==Gamma-glutamyl Transferase (GGT)==
==Gamma-glutamyl Transferase (GGT)==
*Like alkaline phosphatase, also found in abundance in the liver and bile ducts (also spleen, heart, and brain)
*Like alkaline phosphatase, also found in abundance in the liver and bile ducts (also spleen, heart, and brain)
*Elevation in conjunction with an elevation in alkaline phosphatase, suggests biliary stasis/obstruction
*Elevation in conjunction with an elevation in alkaline phosphatase, suggests [[biliary disease|biliary stasis/obstruction]]


==Lactate Dehydrogenase (LDH)==
==Lactate Dehydrogenase (LDH)==
*Found in most body tissues
*Found in most body tissues
*Elevation can occur as a result of cellular rupture (different isozymes can specify tissue type involved)
*Elevation can occur as a result of cellular rupture (different isozymes can specify tissue type involved)
**Cardiac - Demand ischemia, myocarditis
**Cardiac - Demand ischemia, [[myocarditis]]
**Pulmonary - pulmonary embolism
**Pulmonary - [[pulmonary embolism]]
**GI - hepatitis, small or large bowel obstruction
**GI - hepatitis, small or large bowel obstruction
**Hematologic - hemolytic process, ineffective erethropoiesis
**Hematologic - [[hemolytic anemia|hemolytic]] process, ineffective erethropoiesis
**Other - pregnancy, cancer, infection, systemic autoimmune disorders
**Other - pregnancy, cancer, infection, systemic autoimmune disorders



Revision as of 21:47, 26 December 2016

Background

Normal Values

  • ALT: 7 - 55 U/L
  • AST: 8 - 48 U/L
  • Alk Phos: 45 - 115 U/L
  • Albumin: 3.5 to 5.0 g/dL
  • Total protein: 6.3 - 7.9 g/dL
  • Bilirubin: 0.1 - 1.2 mg/dL
  • GGT: 9 - 48 U/L
  • LDH: 122 - 222 U/L
  • PT: 11 - 14 seconds
  • PTT: 25 - 35 seconds
  • INR: 0.8 - 1.2

Albumin / Total Protein

Bilirubin

Aminotransferases (ALT/AST)

  • Elevation is associated with liver damage
  • Elevations in AST >> ALT suggest liver damage from alcoholism (i.e. alcoholic hepatitis)
  • Elevations in ALT >> AST suggest liver damage from another etiology (i.e. infectious hepatitis)

Alkaline Phosphatase

  • Predominantly found in the liver, bile ducts, kidney, and bones
  • Because of its abundant production in biliary duct tissue, elevation reflects a problem with biliary stasis or obstruction
    • Elevation may also occur in patients with increased bone turnover (e.g. 2/2 puberty, osteoporosis, hyperparathyroidism, Paget's disease, etc.)

Gamma-glutamyl Transferase (GGT)

  • Like alkaline phosphatase, also found in abundance in the liver and bile ducts (also spleen, heart, and brain)
  • Elevation in conjunction with an elevation in alkaline phosphatase, suggests biliary stasis/obstruction

Lactate Dehydrogenase (LDH)

  • Found in most body tissues
  • Elevation can occur as a result of cellular rupture (different isozymes can specify tissue type involved)
    • Cardiac - Demand ischemia, myocarditis
    • Pulmonary - pulmonary embolism
    • GI - hepatitis, small or large bowel obstruction
    • Hematologic - hemolytic process, ineffective erethropoiesis
    • Other - pregnancy, cancer, infection, systemic autoimmune disorders

See Also

References