Liver Function Tests (LFTs)

An LFT abnormality may be the initial clue that the patient has liver disease. On the other hand, serious chronic liver disease can be present and not reflected in a a lab profile that does not include all of the following (even this profile might not be 100% sensitive for detection of liver disease).

1. serum:

   • SGPT (ALT): increases suggest hepatocyte injury.

   • SGOT (AST): increases suggest a more general organ or systemic injury (not liver specific).

   • bilirubin: from the normal breakdown of red blood cells and can be elevated due to accelerated breakdown or retarded processing of breakdown products or insufficient excretion.

   • alkaline phosphatase (AP) elevations may point to portal triad and biliary involvement.

   • GGTP (gamma glutamyltranspeptidase)...or GGT: increases reflect induction of inceased cytoplasmic endoplasmic reticulum (medications, alcohol, etc.).

   • LDH (lactic dehydrogenase): an enzyme which, when elevated, suggests hemolysis of RBCs, cellular tumor necrosis/turnover, or ischemic hepatic injury (vascular ischemia or acetaminophen necrosis).

   • albumin...may be decreased, reflecting decreased hepatic protein synthesizing capacity.

   • protein electrophoretic (SPE) pattern...presence of beta gamma bridge, reflecting an IgA-rich polyclonal gammopathy.

2. urine:

   • urobilinogen

   • bile

References:

(posted 6 January 2005)