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Evaluation of abnormal liver function tests.

Swastik Agrawal1, Radha K Dhiman1, Jimmy K Limdi2

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Abnormal liver function tests are common and often not due to liver disease. Understanding patterns of liver test abnormalities aids in diagnosis and targeted investigation for liver injury.

Keywords:
liver function

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Area of Science:

  • Hepatology
  • Clinical Biochemistry

Background:

  • Abnormal liver function tests (LFTs) are frequently found incidentally.
  • Many LFTs lack specificity and can be affected by non-liver related factors.
  • Common LFTs often indicate liver injury (hepatocellular or cholestatic) rather than true liver function.

Purpose of the Study:

  • To review the interpretation of routine liver tests.
  • To discuss the indications and utility of quantitative liver function tests.
  • To guide physicians in evaluating abnormal LFTs.

Main Methods:

  • Review of existing literature on liver function tests.
  • Analysis of patterns of liver test abnormalities.
  • Discussion of diagnostic approaches for liver disease.

Main Results:

  • Interpretation of LFT patterns combined with clinical data can identify liver disease type and etiology.
  • Composite scores (e.g., Model for End Stage Liver Disease) are superior for assessing liver injury severity.
  • Routine tests often reflect liver injury, not function.

Conclusions:

  • A systematic approach using history, examination, and LFT pattern interpretation is crucial.
  • Targeted investigations are guided by the pattern of liver test abnormalities.
  • Quantitative tests offer valuable insights into liver function beyond routine markers.