Liver function tests: Difference between revisions
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==Background== | ==Background== | ||
===Normal Values=== | ===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 disease|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 anemia|hemolytic]] process, ineffective erethropoiesis | |||
**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] | ||
==References== | ==References== | ||
<references/> | <references/> | ||
[[Category:GI]] | [[Category:GI]] | ||
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