Liver Function Tests: Difference between revisions

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<div class="editorbox"> '''Original Editor '''- [[User:Shwe Shwe U Marma|Shwe Shwe U Marma]] '''Top Contributors''' - {{Special:Contributors/{{FULLPAGENAME}}}}</div>
<div class="editorbox"> '''Original Editor '''- [[User:Shwe Shwe U Marma|Shwe Shwe U Marma]] '''Top Contributors''' - {{Special:Contributors/{{FULLPAGENAME}}}}</div>
== Introduction ==
== Introduction ==
Groups of blood tests performed to know the condition of a liver of a patient are known as liver function tests (LFT) or liver panel or hepatic function panel or hepatic panel.<ref>Teshome G, Ambachew S, Fasil A, Abebe M. [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6803769/ Prevalence of liver function test abnormality and associated factors in type 2 diabetes mellitus: a comparative cross-sectional study]. Ejifcc. 2019 Oct;30(3):303.</ref>
Groups of [[Blood Tests|blood tests]] performed to know the condition of a liver of a patient are known as liver function tests (LFT) or liver panel or hepatic function panel or hepatic panel.<ref>Teshome G, Ambachew S, Fasil A, Abebe M. [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6803769/ Prevalence of liver function test abnormality and associated factors in type 2 diabetes mellitus: a comparative cross-sectional study]. Ejifcc. 2019 Oct;30(3):303.</ref>
[[File:Liver organ.png|alt=Image showing liver|center|thumb|337x337px]]
[[File:Liver organ.png|alt=Image showing liver|center|thumb|337x337px]]


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|-
|'''Causes of raised transaminases:'''
|'''Causes of raised transaminases:'''
* Alcohol.
* [[Alcoholism|Alcohol]].
* Medications: non-steroidal anti-inflammatory drugs, antibiotics, HMG Co-A-reductase inhibitors, antiepileptic drugs, antituberculous drugs, herbal medications, illicit drug use.
* Medications: non-steroidal anti-inflammatory drugs, [[antibiotics]], HMG Co-A-reductase inhibitors, antiepileptic drugs, antituberculous drugs, herbal medications, illicit drug use.
* Non-alcoholic steatohepatosis.
* Non-alcoholic steatohepatosis.
* Chronic hepatitis B and C.
* Chronic [[Hepatitis A, B, C|hepatitis]] B and C.
* Autoimmune diseases.
* [[Autoimmune Disorders|Autoimmune]] diseases.
* Hemochromatosis.
* [[Hemochromatosis]].
* Wilson's disease.
* [[Wilson's Disease|Wilson's disease]].
* Congestive cardiac failure and ischaemic hepatitis.
* [[Introduction to Congestive Heart Failure|Congestive cardiac failure]] and ischaemic hepatitis.
* ɑ<sub>1-</sub>Antitrypsin deficiency.
* ɑ<sub>1-</sub>Antitrypsin deficiency.
* Coeliac disease.
* [[Celiac Disease (Coeliac Disease)|Coeliac disease]].
* Endocrine disease: hypothyroidism, Addison's disease.
* Endocrine disease: [[hypothyroidism]], [[Addison's Disease|Addison's]] disease.
* Diseases of striate muscle.
* Diseases of striate muscle.
* Glycogen storage diseases.<ref name=":1">Limdi JK, Hyde GM. [https://pmj.bmj.com/content/79/932/307.full Evaluation of abnormal liver function tests]. Postgraduate medical journal. 2003 Jun 1;79(932):307-12.</ref>
* Glycogen storage diseases.<ref name=":1">Limdi JK, Hyde GM. [https://pmj.bmj.com/content/79/932/307.full Evaluation of abnormal liver function tests]. Postgraduate medical journal. 2003 Jun 1;79(932):307-12.</ref>
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|'''Causes of raised ALP:'''
|'''Causes of raised ALP:'''
* Physiological
* Physiological
** Women in the third trimester of pregnancy.
** Women in the third trimester of [[Physiological changes during pregnancy|pregnancy]].
** Adolescents.
** Adolescents.
** Benign, familial (due to increased intestinal ALP).
** Benign, familial (due to increased intestinal ALP).
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** Drug induced cholestasis—for example, anabolic steroids.
** Drug induced cholestasis—for example, anabolic steroids.
** Adult bile ductopenia.
** Adult bile ductopenia.
** Metastatic liver disease.
** Metastatic [[Liver Disease|liver disease]].
** Bone disease.<ref name=":1" />
** [[Bone]] disease.<ref name=":1" />
|}
|}
{| class="wikitable"
{| class="wikitable"
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* Hepatobiliary disease (often with other liver enzyme abnormalities).
* Hepatobiliary disease (often with other liver enzyme abnormalities).
* Pancreatic disease.
* Pancreatic disease.
* Alcoholism.
* [[Alcoholism]].
* Chronic obstructive pulmonary disease.
* [[COPD (Chronic Obstructive Pulmonary Disease)|Chronic obstructive pulmonary disease]].
* Renal failure.
* Renal failure.
* Diabetes.
* [[Diabetes]].
* Myocardial infarction.
* [[Myocardial Infarction|Myocardial]] infarction.
* Drugs—for example, carbamazepine, phenytoin, and barbiturates.<ref name=":1" />
* Drugs—for example, carbamazepine, phenytoin, and barbiturates.<ref name=":1" />
|}
|}
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* Unconjugated
* Unconjugated
*# Increased bilirubin production.
*# Increased bilirubin production.
*#* Haemolysis.
*#* Hemolysis.
*#* Ineffective erythropoiesis.
*#* Ineffective erythropoiesis.
*#* Blood transfusion.
*#* Blood transfusion.
*#* Resorption of haematomas.
*#* Resorption of hematomas.
*# Decreased hepatic uptake.
*# Decreased hepatic uptake.
*#* Gilbert’s syndrome.
*#* [[Gilbert's Syndrome|Gilbert’s syndrome]].
*#* Drugs—for example, rifampicin.
*#* Drugs—for example, rifampicin.
*# Decreased conjugation.
*# Decreased conjugation.

Revision as of 12:40, 29 November 2020

Original Editor - Shwe Shwe U Marma Top Contributors - Shwe Shwe U Marma, Lucinda hampton and Kim Jackson

Introduction[edit | edit source]

Groups of blood tests performed to know the condition of a liver of a patient are known as liver function tests (LFT) or liver panel or hepatic function panel or hepatic panel.[1]

Image showing liver

Components of Liver Function Tests[edit | edit source]

Alanine Transaminase (ALT); Normal value: 0-45 IU/L

Aspartate Transaminase (AST); Normal value: 0-35 IU/L[2]

Causes of raised transaminases:
Alkaline phosphatase (ALP); Normal value: 30–120 IU/l[2]
Causes of raised ALP:
  • Physiological
    • Women in the third trimester of pregnancy.
    • Adolescents.
    • Benign, familial (due to increased intestinal ALP).
  • Pathological
    • Bile duct obstruction.
    • Primary biliary cirrhosis.
    • Primary sclerosing cholangitis.
    • Drug induced cholestasis—for example, anabolic steroids.
    • Adult bile ductopenia.
    • Metastatic liver disease.
    • Bone disease.[3]
Gammaglutamyl transferase (GGT); Normal value: 0 to 30 IU/L[2]
Causes of raised GGT:
Bilirubin; Normal value: 2 to 17 micromoles/L[2]
Causes of isolated hyperbilirubinemia:
  • Unconjugated
    1. Increased bilirubin production.
      • Hemolysis.
      • Ineffective erythropoiesis.
      • Blood transfusion.
      • Resorption of hematomas.
    2. Decreased hepatic uptake.
    3. Decreased conjugation.
      • Gilbert’s syndrome.
      • Criggler-Najjar syndrome.
      • Physiological jaundice of the newborn.
  • Conjugated
    1. Dubin-Johnson syndrome.
    2. Rotor’s syndrome.[3]
Prothrombin time; Normal value: 10.9 to 12.5 seconds[2]
Causes of prolonged prothrombin time:
  • Vitamin K deficiency.
  • Warfarin therapy.
  • Liver disease.
  • Consumptive coagulopathy.[3]
Albumin; Normal value: 40 to 60 g/L[2]
With progressive liver disease serum albumin levels fall, reflecting decreased synthesis. Albumin levels are dependant on a number of other factors such as the nutritional status, catabolism, hormonal factors, and urinary and gastrointestinal losses.[3]

[4]

Resources[edit | edit source]

References[edit | edit source]

  1. ↑ Teshome G, Ambachew S, Fasil A, Abebe M. Prevalence of liver function test abnormality and associated factors in type 2 diabetes mellitus: a comparative cross-sectional study. Ejifcc. 2019 Oct;30(3):303.
  2. ↑ 2.0 2.1 2.2 2.3 2.4 2.5 Lala V, Goyal A, Bansal P, Minter D. Liver function tests. StatPearls. 2020 Apr 28.
  3. ↑ 3.0 3.1 3.2 3.3 3.4 3.5 Limdi JK, Hyde GM. Evaluation of abnormal liver function tests. Postgraduate medical journal. 2003 Jun 1;79(932):307-12.
  4. ↑ MedCram - Medical Lectures Explained CLEARLY. Liver Function Tests (LFTs) Explained Clearly by MedCram.com. Available from: https://www.youtube.com/watch?v=bFdTgty0T0I [Last accessed 29 November, 2020]
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