Budd-Chiari syndrome laboratory findings

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief:

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Laboratory Findings

When Budd-Chiari syndrome is suspected, measurements are made of :

• Liver enzyme levels
• Creatinine
• Urea
• Electrolytes
• 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
• Severe hepatic necrosis and lactic acidosis may be present as well. Caudate lobe hypertrophy is often present. The majority of patients have a slower-onset form of Budd-Chiari syndrome. This can be painless. Patients may progress to cirrhosis and show the signs of liver failure.

• Laboratory findings consistent with the diagnosis of acute and fulminant BCS include:
  • Elevated Serum aspartate 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 level 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.