Abnormal Liver Function Tests: Elevations in ALT and AST, Which Predominate Over Elevations of Alkaline Phosphatase (ALP), 5'-NT, and/or Gamma Glutamyltransferase (GGT)
If the diseases in the list below increase in severity, there may be findings suggestive of cirrhosis with or without hepatic failure:
Viral hepatitis, multiple forms (see chapters on Viral Hepatitis A, B, and C)
Suggested Additional Lab Testing
Total bilirubin and unconjugated bilirubin are markedly elevated in hepatic failure.
Prothrombin time is elevated as a result of decreased synthesis of coagulation factors.
Aminotransferase levels may increase and then decrease rapidly when there is significant and permanent loss of hepatocytes.
Serum creatinine may be elevated as evidence of hepatorenal syndrome.
Low blood glucose, elevated white blood cell (WBC) count, low platelet count, and low serum albumin are also common in hepatic failure.
Serum ceruloplasmin is low (90% of the serum copper is complexed to this protein).
Twenty-four-hour urinary copper excretion is elevated.
Liver function tests may be normal, but, as the disease progresses, abnormal values appear.
Serum copper is usually elevated but may be normal or low.
Hepatic copper concentration is markedly elevated because of the low amount of serum ceruloplasmin; an elevated hepatic copper concentration is highly indicative of Wilson disease.
Serum alpha-1-antitrypsin level is low.
Abnormal liver function tests are detectable in adults who suffer liver damage, but they may be normal in early stages of disease.
Liver biopsy can show characteristic red cytoplasmic granules demonstrable by a PAS stain of the liver. Hepatocellular carcinoma requires histopathologic examination of a liver biopsy for diagnosis.
Copyright © 2017, 2013 Decision Support in Medicine, LLC. All rights reserved.
No sponsor or advertiser has participated in, approved or paid for the content provided by Decision Support in Medicine LLC. The Licensed Content is the property of and copyrighted by DSM.
Sign Up for Free e-newsletters
Psychiatry Advisor Articles
- Rapid Cycling in Bipolar Disorder: Overview and Expert Perspectives
- Posttraumatic Stress Disorder Associated With Reduced Brain Volume
- First-Episode Drug-Naive Patients With Schizophrenia More Likely to Attempt Suicide
- ADHD Medications Compared for Efficacy, Tolerability in Children and Adults
- Early Childhood Out-of-Home Placement Associated With Adverse Outcomes in Adulthood
- The Psychology of Hoarding Disorder: Approaches for Treatment
- Mind-Body Therapy and Psychiatry: Ancient Tools for Modern Practice
- Smartphone Applications for Depression and Anxiety: Are They Ready for Widespread Use?
- The Many Misconceptions of Catatonia: Treatment Is Often Successful With the Right Knowledge
- Marijuana Use Associated With Poorer Depression Outcomes, Increased Suicidal Ideation
- Healthcare Community Should Favor More Restrictive Alcohol Policies
- How to Respond to a Patient's Request for Prayer: A Clinician's Dilemma
- Major Barriers to Useful Risk Prediction Must Be Overcome to Reach the Full Potential of Big Data
- ACA Coverage Gains Include Workers Without Insurance
- Steps Provided for Discharging Patients From Practice