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[Elevated liver function tests - as incidental finding in general practice].

Claudia Keerl1,2, Christine Bernsmeier1,2

  • 1Gastroenterologie und Hepatologie, Clarunis Universitäres Bauchzentrum Basel, St. Claraspital und Universitätsspital Basel.

Therapeutische Umschau. Revue Therapeutique
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Summary
This summary is machine-generated.

Elevated liver function tests are common incidental findings. A systematic approach combining medical history, clinical exam, and targeted tests is crucial for diagnosing liver disease, which is a rising cause of death.

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Area of Science:

  • Hepatology
  • Internal Medicine
  • Diagnostic Medicine

Background:

  • Elevated liver function tests (LFTs) are incidentally found in 25% of patients with non-specific symptoms or during routine checkups.
  • Approximately 2.5% of the general population exhibit elevated LFTs, while liver disease can be present without abnormal LFTs.
  • Liver disease is a significant cause of mortality, ranking as the fifth leading cause of death globally, with rising prevalence due to NAFLD, ARLD, and viral hepatitis.

Purpose of the Study:

  • To outline a diagnostic algorithm for evaluating elevated liver function tests in general practice.
  • To address the diagnostic challenges posed by the wide range of differential diagnoses and coexisting etiologies in liver disease.
  • To emphasize the prognostic implications of timely and accurate liver disease diagnosis.

Main Methods:

  • Initial steps involve a detailed medical history and thorough clinical examination to narrow down potential causes.
  • Screening tests for differential liver diseases are performed based on the level of LFT elevation and clinical presentation (hepatitis or cholestasis).
  • Diagnostic tools include laboratory tests, ultrasound, non-invasive methods (elastography, MRI/MRCP/CT), and in select cases, invasive methods (liver biopsy, ERCP).

Main Results:

  • The study delineates a systematic diagnostic approach to elevated LFTs.
  • The approach aims to efficiently identify the underlying cause of liver dysfunction.
  • Algorithms are presented to guide the diagnostic process.

Conclusions:

  • A structured diagnostic pathway is essential for managing patients with elevated LFTs.
  • Early and accurate diagnosis of liver disease is critical due to its significant mortality and rising prevalence.
  • The described approach integrates various diagnostic modalities to improve patient outcomes.