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[The patient with slightly increased liver function tests].

K P Maier1

  • 1Fachbereich Gastroenterologie, Akademisches Lehrkrankenhaus der Universität Tübingen, Städtische Kliniken Esslingen. kp.maier@kliniken-es.de

Praxis
|March 5, 2005
PubMed
Summary
This summary is machine-generated.

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Interpreting abnormal liver chemistry tests involves confirming results and identifying patterns. Differentiating between necrotic and cholestatic patterns guides further investigation into potential liver diseases using serologic tests and other diagnostics.

Area of Science:

  • Hepatology
  • Clinical Chemistry

Background:

  • Increased use of serum blood chemistries leads to more abnormal liver enzyme tests.
  • Physicians must interpret these abnormal results to diagnose underlying conditions.

Purpose of the Study:

  • To outline an approach for interpreting abnormal liver chemistry tests.
  • To differentiate between necrotic and cholestatic patterns of liver injury.
  • To guide the diagnostic workup for elevated liver enzymes.

Main Methods:

  • Initial confirmation of abnormal results by repeating tests.
  • Classification of liver enzyme patterns into "necrotic" (ALT/AST elevation) or "cholestatic" (g-GT/alkaline phosphatase elevation).
  • Utilizing non-invasive serologic tests to exclude hepatic diseases.

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Main Results:

  • Common causes of elevated aminotransferases include hepatitis B/C, autoimmune hepatitis, NASH, hemochromatosis, Wilson disease, and celiac sprue.
  • Cholestatic patterns suggest primary biliary cirrhosis, primary sclerosing cholangitis, drug-induced liver injury, or granulomatous hepatitis.
  • Non-invasive tests are the primary diagnostic tool, with imaging and biopsy reserved for inconclusive cases.

Conclusions:

  • A systematic approach to interpreting abnormal liver tests is crucial for accurate diagnosis.
  • Differentiating between necrotic and cholestatic patterns aids in narrowing down potential causes of liver disease.
  • A combination of serologic testing, imaging, and biopsy is essential for definitive diagnosis when initial tests are inconclusive.