Elevated Liver Enzymes: Emergency Department-Focused Management.

Area of Science:

• Biochemistry
• Hepatology
• Emergency Medicine

Background:

• Liver function test (LFT) abnormalities are increasingly common in emergency departments.
• Automated laboratory testing contributes to the rise in detected LFT irregularities.
• Not all LFT abnormalities indicate underlying liver pathology.

Purpose of the Study:

• To provide emergency physicians with an overview of evaluating and managing patients presenting with elevated LFTs.
• To discuss the biochemical basis of LFTs and their interpretation.

Main Methods:

• Review of biochemical tests for liver function.
• Discussion of the biological basis of LFTs.
• Development of an algorithmic approach for interpreting LFT abnormalities.
• Categorization of elevations into mild, moderate, and severe.

Main Results:

• LFTs can be categorized into hepatocellular, cholestatic, or functioning liver markers.
• Algorithmic assessment involves separating disease processes and evaluating the magnitude of enzymatic elevation.
• Correlation of laboratory findings with clinical presentation is crucial.

Conclusions:

• Understanding LFT biochemistry aids in correlating lab results with clinical presentation.
• An algorithmic approach helps narrow the differential diagnosis for elevated LFTs.
• This strategy assists providers in appropriate management and evaluation of patients with abnormal LFTs.