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== | ||
| Line 32: | Line 32: | ||
==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 | ||
==See Also== | ==See Also== | ||
==External Links== | |||
*[http://lifeinthefastlane.com/investigations/liver-function-tests/ LITFL LFTs] | *[http://lifeinthefastlane.com/investigations/liver-function-tests/ LITFL LFTs] | ||
*[http://www.mdcalc.com/meld-score-model-for-end-stage-liver-disease-12-and-older/ MDCalc - MELD Score] | *[http://www.mdcalc.com/meld-score-model-for-end-stage-liver-disease-12-and-older/ MDCalc - MELD Score] | ||
Latest revision as of 02:05, 21 February 2021
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