Budd-Chiari syndrome laboratory findings: Difference between revisions
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{{Budd-Chiari syndrome}} | {{Budd-Chiari syndrome}} | ||
{{CMG}}; {{AE}} | {{CMG}}; {{AE}}{{Mazia}} | ||
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==Overview== | ==Overview== | ||
When Budd-Chiari syndrome is suspected, | Budd-Chiari syndrome should be suspected in patients with predisposing conditions such as [[malignancy]] or [[hypercoagulable states]]. When Budd-Chiari syndrome is suspected, [[liver function tests]] and levels of [[creatinine]], [[urea]], [[Electrolyte|electrolytes]], [[LDH]] should be evlauated. [[Liver biopsy]] for the presence of [[antiphospholipid antibodies]] is usually tested for [[patients]] with primary BCS. [[Bone marrow biopsy]] can be used to diagnose associated [[Myeloproliferative disease|myeloproliferative disorders]], which are common in BCS. Laboratory findings consistent with the [[diagnosis]] of [[acute]] and [[fulminant]] BCS include, elevated [[Aspartate aminotransferase|serum aspartate aminotransferase]] and [[alanine aminotransferase]] levels (may be more than five times the upper limit of the normal range) and elevated [[Alkaline phosphatase|serum alkaline phosphatase]] and [[bilirubin]] levels, decreased [[Albumin|serum albumin level]]. [[Ascitic]] fluid examination shows: [[Total protein]] more than 2.5 g per deciliter and [[white blood cells]] are usually less than 500/μL. Additional [[hematological]] tests are recommended to evaluate for [[hypercoagulability]]. | ||
==Laboratory Findings== | ==Laboratory Findings== | ||
*Suspect Budd-Chiari syndrome in patients with predisposing conditions such as malignancy or hypercoagulable states. | *Suspect Budd-Chiari syndrome in patients with predisposing conditions such as [[malignancy]] or [[hypercoagulable states]]. | ||
*When Budd-Chiari syndrome is suspected, measurements are made of:<ref name="pmid28922103">{{cite journal |vauthors=Grus T, Lambert L, Grusová G, Banerjee R, Burgetová A |title=Budd-Chiari Syndrome |journal=Prague Med Rep |volume=118 |issue=2-3 |pages=69–80 |year=2017 |pmid=28922103 |doi=10.14712/23362936.2017.6 |url=}}</ref><ref name="pmid24923240">{{cite journal |vauthors=Copelan A, Remer EM, Sands M, Nghiem H, Kapoor B |title=Diagnosis and management of Budd Chiari syndrome: an update |journal=Cardiovasc Intervent Radiol |volume=38 |issue=1 |pages=1–12 |year=2015 |pmid=24923240 |doi=10.1007/s00270-014-0919-9 |url=}}</ref> | *When Budd-Chiari syndrome is suspected, measurements are made of:<ref name="pmid28922103">{{cite journal |vauthors=Grus T, Lambert L, Grusová G, Banerjee R, Burgetová A |title=Budd-Chiari Syndrome |journal=Prague Med Rep |volume=118 |issue=2-3 |pages=69–80 |year=2017 |pmid=28922103 |doi=10.14712/23362936.2017.6 |url=}}</ref><ref name="pmid24923240">{{cite journal |vauthors=Copelan A, Remer EM, Sands M, Nghiem H, Kapoor B |title=Diagnosis and management of Budd Chiari syndrome: an update |journal=Cardiovasc Intervent Radiol |volume=38 |issue=1 |pages=1–12 |year=2015 |pmid=24923240 |doi=10.1007/s00270-014-0919-9 |url=}}</ref> | ||
**[[Liver enzyme]] levels | **[[Liver enzyme]] levels | ||
**[[Electrolyte]]s | **[[Electrolyte]]s | ||
**Serum alkaline phosphatase levels | **[[Alkaline phosphatase|Serum alkaline phosphatase levels]] | ||
**[[Creatinine]] | **[[Creatinine]] | ||
**[[Urea]] | **[[Urea]] | ||
**Ascitic fluid analysis | **[[Ascites Paracentesis|Ascitic fluid analysis]] | ||
**[[lactate dehydrogenase|LDH]] | **[[lactate dehydrogenase|LDH]] | ||
**[[Liver biopsy]] is nonspecific but sometimes necessary to differentiate between Budd-Chiari syndrome and other causes of hepatomegaly and ascites, such as [[galactosemia]] or [[Reye's syndrome]]. | **[[Liver biopsy]] is nonspecific but sometimes necessary to differentiate between Budd-Chiari syndrome and other causes of [[hepatomegaly]] and [[ascites]], such as [[galactosemia]] or [[Reye's syndrome]]. | ||
**Factor V Leiden and Factor II (prothrombin) mutations, for the presence of antiphospholipid antibodies, is usually tested for patients with primary BCS. | **[[Factor V Leiden]] and [[Factor II|Factor II (prothrombin) mutations]], for the presence of [[antiphospholipid antibodies]], is usually tested for patients with primary BCS. | ||
**Bone marrow biopsy can be used to diagnose associated myeloproliferative disorders are common in BCS. | **[[Bone marrow biopsy]] can be used to diagnose associated [[Myeloproliferative disease|myeloproliferative disorders]] are common in BCS. | ||
*Laboratory findings consistent with the diagnosis of acute and fulminant BCS include: | *Laboratory findings consistent with the [[diagnosis]] of [[acute]] and [[fulminant]] BCS include: | ||
**Elevated | **Elevated [[Aspartate aminotransferase|serum aspartate aminotransferase]] and [[alanine aminotransferase]] levels may be more than five times the upper limit of the normal range. | ||
**Elevated | **Elevated serum [[alkaline phosphatase]] and [[Bilirubin|bilirubin levels]], decreased [[Albumin|serum albumin level]]. | ||
*Ascitic fluid examination shows: | *[[Ascitic tap|Ascitic fluid examination]] shows: | ||
**Total protein | **[[Total protein]] more than 2.5 g per deciliter | ||
**White blood cells are usually less than 500/μL. | **[[White blood cells]] are usually less than 500/μL. | ||
*Additional Hematological tests are recommended to evaluate for hypercoagulability. | *Additional Hematological tests are recommended to evaluate for [[hypercoagulability]]. | ||
==References== | ==References== | ||
Latest revision as of 19:51, 30 November 2017
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Mazia Fatima, MBBS [2]
Overview
Budd-Chiari syndrome should be suspected in patients with predisposing conditions such as malignancy or hypercoagulable states. When Budd-Chiari syndrome is suspected, liver function tests and levels of creatinine, urea, electrolytes, LDH should be evlauated. Liver biopsy for the presence of antiphospholipid antibodies is usually tested for patients with primary BCS. Bone marrow biopsy can be used to diagnose associated myeloproliferative disorders, which are common in BCS. Laboratory findings consistent with the diagnosis of acute and fulminant BCS include, elevated serum aspartate aminotransferase and alanine aminotransferase levels (may be more than five times the upper limit of the normal range) and elevated serum alkaline phosphatase and bilirubin levels, decreased serum albumin level. Ascitic fluid examination shows: Total protein more than 2.5 g per deciliter and white blood cells are usually less than 500/μL. Additional hematological tests are recommended to evaluate for hypercoagulability.
Laboratory Findings
- Suspect Budd-Chiari syndrome in patients with predisposing conditions such as malignancy or hypercoagulable states.
- When Budd-Chiari syndrome is suspected, measurements are made of:[1][2]
- Liver enzyme levels
- Electrolytes
- Serum alkaline phosphatase levels
- Creatinine
- Urea
- Ascitic fluid analysis
- LDH
- Liver biopsy is nonspecific but sometimes necessary to differentiate between Budd-Chiari syndrome and other causes of hepatomegaly and ascites, such as galactosemia or Reye's syndrome.
- Factor V Leiden and Factor II (prothrombin) mutations, for the presence of antiphospholipid antibodies, is usually tested for patients with primary BCS.
- Bone marrow biopsy can be used to diagnose associated myeloproliferative disorders are common in BCS.
- Laboratory findings consistent with the diagnosis of acute and fulminant BCS include:
- Elevated serum aspartate aminotransferase and alanine aminotransferase levels may be more than five times the upper limit of the normal range.
- Elevated serum alkaline phosphatase and bilirubin levels, decreased serum albumin level.
- Ascitic fluid examination shows:
- Total protein more than 2.5 g per deciliter
- White blood cells are usually less than 500/μL.
- Additional Hematological tests are recommended to evaluate for hypercoagulability.
References
- ↑ Grus T, Lambert L, Grusová G, Banerjee R, Burgetová A (2017). "Budd-Chiari Syndrome". Prague Med Rep. 118 (2–3): 69–80. doi:10.14712/23362936.2017.6. PMID 28922103.
- ↑ Copelan A, Remer EM, Sands M, Nghiem H, Kapoor B (2015). "Diagnosis and management of Budd Chiari syndrome: an update". Cardiovasc Intervent Radiol. 38 (1): 1–12. doi:10.1007/s00270-014-0919-9. PMID 24923240.