Alcoholic liver disease laboratory findings

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief:

Overview

Pertinent laboratory findings include elevated liver enzymes, with an AST to ALT ratio of about 2 to 1. An elevated level of gamma-glutamyl transferase is an indicator of excessive alcohol consumption. Other findings include; and increase serum bilirubin, increased alkaline phosphatase, a prolonged prothrombin time, decreased serum albumin, thrombocytopenia, leukocytosis, folate deficiency, and a macrocytic anemia.

Laboratory Findings

Hemogram

• Macrocytic anemia
• Thrombocytopenia (causes are toxic effect of alcohol on platelet)
• Leukocytosis

Liver Function Tests

Diagnosis typically relies on laboratory tests of three liver enzymes: gamma–glutamyl transferase (GGT), aspartate aminotransferase (AST), and alanine aminotransferase (ALT). Liver disease is the most likely diagnosis if the AST level is more than twice that of ALT , a ratio some studies have found in more than 80 percent of alcoholic liver disease patients. An elevated level of the liver enzyme GGT is another gauge of heavy alcohol use and liver injury. Of the three enzymes, GGT is the best indicator of excessive alcohol consumption, but GGT is present in many organs and is increased by other drugs as well, so high GGT levels do not necessarily mean the patient is abusing alcohol.

• Raised serum bilirubin
• Elevated liver enzyme
  • AST usually elevated more than ALT (commonly by factor of 2 or more)
  • AST usually elevated but not more than 300 u/L
  • Elevated alkaline phosphatase (infrequently more than 3 times of normal)
• Prolonged prothrombin time (> 6 seconds above control)
• Serum protein
  • Decreased serum albumin
  • Increased gamma globulin
• Iron studies
  • Increased transferrin saturation, hepatic iron stores, and sideroblastic anemia
• Folic acid deficiency

2010 AASLD/ACG Alcoholic Liver Disease Guidelines (DO NOT EDIT)

Laboratory Tests : Guidelines (DO NOT EDIT)

Class I

1. " For patients with a history of alcohol abuse or excess and evidence of liver disease, further laboratory tests should be done to exclude other etiologies and to confirm the diagnosis. (Level of evidence: C) "