Page 15 - Clinical Biochemistry 08PB804

• To interpret these, the physician will look at the entire picture of the hepatocellular disease
and biliary tract disease to determine which the primary abnormality is.
• The function of the liver cannot be evaluated with any single test. Because of the organ’s
many functions.
Causes of a Hepatocellular Pattern of LFTs
Marked elevations in ALT/AST > x5x (symptomatic)
• Viral hepatitis.
• Ischaemic hepatitis.
• Autoimmune hepatitis.
• Drug/toxins e.g. alcoholic hepatitis.
Mild/Moderate elevations in ALT/AST < x5x (asymptomatic)
• Chronic Hepatitis.
• NAFLD/NASH – associated with obesity, T2DM, Hyerlipidaemia.
• Drugs.
Causes of a cholestatic pattern of LFTs
Elevated ALP and GGT ± Bilirubin, relative to transaminases
• Medications
• Sepsis
• Cholelithiasis (CBD)
• Malignancy
• Pregnancy hormones cause cholestasis
GGT is useful in differentiating Liver as a cause of elevated ALP
Specialised Liver-related tests
 Viral Hepatitis Screen – A, B, C etc.
 Serum protein electrophoresis.