Alcoholic liver disease laboratory findings: Difference between revisions
Jump to navigation
Jump to search
| Line 11: | Line 11: | ||
===Liver Function Tests=== | ===Liver Function Tests=== | ||
Diagnosis typically relies on laboratory tests of three liver enzymes: [[ | Diagnosis typically relies on laboratory tests of three liver enzymes: [[gamma–glutamyl transferase]] (GGT), [[aspartate aminotransferase]] (AST), and [[alanine aminotransferase]] (ALT). [[Liver disease]] is the most likely diagnosis if the AST level is more than twice that of ALT <ref>Marsano, L.S.; Mendez, C.; Hill, D.; et al. Diagnosis and treatment of alcoholic liver disease and its complications. Alcohol Research & Health 27(3):247–256, 2003</ref>, a ratio some studies have found in more than 80 percent of alcoholic liver disease patients. An elevated level of the liver enzyme GGT is another gauge of heavy alcohol use and liver injury. Of the three enzymes, GGT is the best indicator of excessive alcohol consumption, but GGT is present in many organs and is increased by other drugs as well, so high GGT levels do not necessarily mean the patient is abusing alcohol. | ||
* Raised serum bilirubin | * Raised serum [[bilirubin]] | ||
* Elevated liver enzyme | * Elevated liver enzyme | ||
** '''AST usually elevated more than ALT (commonly by factor of 2 or more)''' | ** '''AST usually elevated more than ALT (commonly by factor of 2 or more)''' | ||
** AST usually elevated but not more than 300 u/L | ** AST usually elevated but not more than 300 u/L | ||
** Elevated alkaline phosphatase (infrequently more than 3 times of normal) | ** Elevated [[alkaline phosphatase]] (infrequently more than 3 times of normal) | ||
* Prolonged prothrombin time (> 6 seconds above control) | * Prolonged [[prothrombin time]] (> 6 seconds above control) | ||
* Serum protein | * Serum protein | ||
** Decreased serum albumin | ** Decreased [[serum albumin]] | ||
** Increased gamma globulin | ** Increased [[gamma globulin]] | ||
* Iron studies | * Iron studies | ||
** Increased transferrin saturation, hepatic iron stores, and sideroblastic anemia | ** Increased [[transferrin saturation]], hepatic iron stores, and [[sideroblastic anemia]] | ||
* Folic acid deficiency | * [[Folic acid]] deficiency | ||
===2010 AASLD/ACG Alcoholic Liver Disease Guidelines : Laboratory Tests (DO NOT EDIT)<ref name="urlwww.aasld.org">{{cite web |url=http://www.aasld.org/practiceguidelines/Documents/Bookmarked%20Practice%20Guidelines/AlcoholicLiverDisease1-2010.pdf |title=www.aasld.org |format= |work= |accessdate=2012-10-27}}</ref>=== | ===2010 AASLD/ACG Alcoholic Liver Disease Guidelines : Laboratory Tests (DO NOT EDIT)<ref name="urlwww.aasld.org">{{cite web |url=http://www.aasld.org/practiceguidelines/Documents/Bookmarked%20Practice%20Guidelines/AlcoholicLiverDisease1-2010.pdf |title=www.aasld.org |format= |work= |accessdate=2012-10-27}}</ref>=== | ||
Revision as of 16:18, 28 October 2012
|
Alcoholic liver disease Microchapters |
|
Diagnosis |
|---|
|
Treatment |
|
Case Studies |
|
Alcoholic liver disease laboratory findings On the Web |
|
American Roentgen Ray Society Images of Alcoholic liver disease laboratory findings |
|
Risk calculators and risk factors for Alcoholic liver disease laboratory findings |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Laboratory Findings
Hemogram
- Macrocytic anemia
- Thrombocytopenia (causes are toxic effect of alcohol on platelet)
- Leukocytosis
Liver Function Tests
Diagnosis typically relies on laboratory tests of three liver enzymes: gamma–glutamyl transferase (GGT), aspartate aminotransferase (AST), and alanine aminotransferase (ALT). Liver disease is the most likely diagnosis if the AST level is more than twice that of ALT [1], a ratio some studies have found in more than 80 percent of alcoholic liver disease patients. An elevated level of the liver enzyme GGT is another gauge of heavy alcohol use and liver injury. Of the three enzymes, GGT is the best indicator of excessive alcohol consumption, but GGT is present in many organs and is increased by other drugs as well, so high GGT levels do not necessarily mean the patient is abusing alcohol.
- Raised serum bilirubin
- Elevated liver enzyme
- AST usually elevated more than ALT (commonly by factor of 2 or more)
- AST usually elevated but not more than 300 u/L
- Elevated alkaline phosphatase (infrequently more than 3 times of normal)
- Prolonged prothrombin time (> 6 seconds above control)
- Serum protein
- Decreased serum albumin
- Increased gamma globulin
- Iron studies
- Increased transferrin saturation, hepatic iron stores, and sideroblastic anemia
- Folic acid deficiency
2010 AASLD/ACG Alcoholic Liver Disease Guidelines : Laboratory Tests (DO NOT EDIT)[2]
| Class I |
| 1. " For patients with a history of alcohol abuse or excess and evidence of liver disease, further laboratory tests should be done to exclude other etiologies and to confirm the diagnosis. (Level of evidence: C) " |
References
- ↑ Marsano, L.S.; Mendez, C.; Hill, D.; et al. Diagnosis and treatment of alcoholic liver disease and its complications. Alcohol Research & Health 27(3):247–256, 2003
- ↑ "www.aasld.org" (PDF). Retrieved 2012-10-27.