Review article
Laboratory diagnosis of liver disease
Sanja Balen
; Klinički zavod za transfuzijsku medicinu, KBC Rijeka, Rijeka
Štefica Dvornik
; Klinički zavod za laboratorijsku dijagnostiku, KBC Rijeka, Rijeka
Abstract
There are three groups of tests for laboratory diagnostic of liver disease. The first group comprises laboratory tests which indicate damage of liver cells and liver function. The second group consists of tests which can determine the cause of liver disease, and the third group comprises functional dynamic tests which show the ability of liver to release harmful metabolic products from the body. Typical recommendations for laboratory diagnostics of liver
disease include initial screening tests (enzyme activity of alanine aminotransferase (ALT), aspartat aminotransferase (AST) and alkaline phosphatase (ALP) in serum, concentration of bilirubin
and eventually total protein and albumine concentrations), after which depending on obtained results, the physician can expand the diagnostics and perform other laboratory tests. Laboratory tests can help not only in establishing a diagnosis, but also in clinical prognoses and monitoring the course of liver disease. Activities of ALT and AST in serum indicate the damage of liver cells, while activities of ALP and gama-glutamyl transferase (GGT) indicate disorders in cholestasis. Liver is the main organ where coagulation and fibrinolysis factors and their inhibitors
are synthesized, this liver damage will affect haemostasis. Coagulation disorders depend on the degree of the damage of liver parenchyma. In acute hepatitis there is usually moderate decrease of F VII and vitamin K dependent factors, resulting in a slight prolongation of prothrombin
time, while fibrinogen and factor VIII can be elevated. In liver cirrhosis the degree of haemostatic disorders depends on the damage of liver cells and is a good indicator of liver function. Laboratory tests which can determine the cause of liver disease are: viral markers, tumor markers, auto antibodies, specific proteins and micronutrients.
Keywords
biochemical marker; laboratory diagnostics; liver disease
Hrčak ID:
71751
URI
Publication date:
5.9.2011.
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