Page 19 - Clinical Biochemistry 08PB804

• It is used often times to confirm that the alkaline phosphatase is of the hepatic etiology.

• Medications (barbiturates and phenytoin) commonly cause GGT to be elevated.

• Liver toxins such as alcohol can also cause increases in GGT.

Albumin

• Major plasma protein, synthesized exclusively by the liver.

• Albumin can be decreased in any chronic illness, but in the setting of chronic liver disease,
decreased serum albumin (normal 3.5-5.5 g/dL) is indicative of severe hepatic disease and liver
synthetic dysfunction.

• Other causes of decreased serum albumin include nephrotic syndrome and malnutrition.

International Normalized Ratio (INR)

• International normalized ratio (INR) is a blood-clotting test. It is a test used to measure how
quickly your blood forms a clot, compared with normal clotting time.

• A normal INR is 1.0. Each increase of 0.1 means the blood is slightly thinner (it takes
longer to clot). INR is related to the prothrombin time (PT).

• If there is serious liver disease and cirrhosis, the liver may not produce the normal amount
of proteins and then the blood is not able to clot normally.

Platelet count

• Platelets are fragments of cells that form the primary mechanism in blood clots.

• When there is an injury to a blood vessel or tissue and bleeding begins, platelets help stop
bleeding in three ways. They adhere to the injury site, Clump together (aggregate) with other
platelets, Release chemical compounds that stimulate further aggregation of other platelets.

• Can manifest from decreased thrombopoietin production and accelerated platelet
destruction.

• Individuals with liver disease develop a large spleen.

• As this process occurs platelets are trapped within the sinusoids (small pathways within the
spleen) of the spleen. While the trapping of platelets is a normal function for the spleen, in liver