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Laboratory evaluation of liver disease
The Veterinary Clinics of North America. Small Animal Practice
|January 1, 1985
Summary
Identifying liver disease relies on a panel of laboratory tests, including ALT and bilirubin, to detect hepatobiliary conditions. Definitive diagnosis and prognosis require serial evaluations and liver biopsy when needed.
Area of Science:
- Clinical Chemistry
- Hepatology
- Diagnostic Laboratory Medicine
Background:
- Laboratory diagnostics are crucial for identifying the presence of liver disease.
- Currently, no single test provides a specific diagnosis or accurate prognosis for liver conditions.
- A minimum database of tests is essential for initial hepatobiliary disease screening.
Purpose of the Study:
- To outline a comprehensive laboratory approach for identifying and assessing liver disease.
- To discuss the interpretation of routine and specialized liver function tests.
- To highlight the importance of serial testing and liver biopsy for definitive diagnosis.
Main Methods:
- Utilizing a minimum database including ALT, SAP, bilirubin (serum and urine), cholesterol, albumin, BUN, glucose, red cell morphology, and urine sediment.
- Analyzing patterns of test results to differentiate between hepatocellular and biliary disease.
- Employing sensitive liver function tests like BSP retention and ammonia tolerance for suspected cases with marginal routine test changes.
Main Results:
- Routine laboratory tests can help identify the presence of hepatobiliary disease and sometimes suggest whether it is primarily hepatocellular or biliary.
- Extreme abnormal values in routine tests may provide an estimate of disease severity.
- Serial evaluations and liver biopsy are key for definitive answers when routine tests are inconclusive.
Conclusions:
- A structured approach using a combination of routine and specialized laboratory tests is vital for liver disease evaluation.
- Careful interpretation, serial monitoring, and consideration of liver biopsy are essential for accurate diagnosis and prognosis.
- Future advancements in measuring bile acids and understanding newer markers (ARG, GGT, ICG) may offer more sensitive, noninvasive diagnostic methods.