Alcoholic liver disease laboratory findings: Difference between revisions

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{{Alcoholic liver disease}}
{{Alcoholic liver disease}}
{{CMG}}; {{AE}}
{{CMG}}; {{AE}} {{MKA}}


==Overview==
==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==
==Laboratory Findings==
===Hemogram===
* [[Macrocytic anemia]]
* [[Thrombocytopenia]] (causes are toxic effect of alcohol on platelet)
* [[Leukocytosis]]


===Liver Function Tests===
*Elevated liver enzymes:<ref name="pmid15535453">{{cite journal |vauthors=Marsano LS, Mendez C, Hill D, Barve S, McClain CJ |title=Diagnosis and treatment of alcoholic liver disease and its complications |journal=Alcohol Res Health |volume=27 |issue=3 |pages=247–56 |year=2003 |pmid=15535453 |doi= |url=}}</ref>
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 <ref>Marsano, L.S.; Mendez, C.; Hill, D.; et al. Diagnosis and treatment of alcoholic liver disease and its complications. Alcohol Research & Health 27(3):247–256, 2003</ref>, 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.
**Aspartate aminotransferase (AST) level will be greater than that of Alanine aminotransferase (ALT).
**AST and ALT levels both will be below 300 IU/ml.
**The key to diagnosis of alcoholic liver disease is that the AST to ALT ratio will be greater than 2.
*Elevated levels of gamma glutamyltransferase (GGT) will indicate heavy alcohol use and may also indicate liver injury. This test is sensitive but not specific.<ref name="pmid15535453">{{cite journal |vauthors=Marsano LS, Mendez C, Hill D, Barve S, McClain CJ |title=Diagnosis and treatment of alcoholic liver disease and its complications |journal=Alcohol Res Health |volume=27 |issue=3 |pages=247–56 |year=2003 |pmid=15535453 |doi= |url=}}</ref>
*Elevated triglyceride levels (hypertriglyceridemia).
*Elevated uric acid levels (hyperuricemia)
*Low potassium levels (hypokalemia)
*Low magnesium levels (hypomagnesemia)
*Elevated index of red blood cell size; increased mean corpuscular erythrocyte volume (MCV)
 
 
 


* 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)<ref name="urlwww.aasld.org">{{cite web |url=http://www.aasld.org/practiceguidelines/Documents/Bookmarked%20Practice%20Guidelines/AlcoholicLiverDisease1-2010.pdf |title=www.aasld.org |format= |work= |accessdate=2012-10-27}}</ref>==
==2010 AASLD/ACG Alcoholic Liver Disease Guidelines (DO NOT EDIT)<ref name="urlwww.aasld.org">{{cite web |url=http://www.aasld.org/practiceguidelines/Documents/Bookmarked%20Practice%20Guidelines/AlcoholicLiverDisease1-2010.pdf |title=www.aasld.org |format= |work= |accessdate=2012-10-27}}</ref>==

Revision as of 20:22, 18 December 2017

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: M. Khurram Afzal, MD [2]

Overview

Laboratory Findings

  • Elevated liver enzymes:[1]
    • Aspartate aminotransferase (AST) level will be greater than that of Alanine aminotransferase (ALT).
    • AST and ALT levels both will be below 300 IU/ml.
    • The key to diagnosis of alcoholic liver disease is that the AST to ALT ratio will be greater than 2.
  • Elevated levels of gamma glutamyltransferase (GGT) will indicate heavy alcohol use and may also indicate liver injury. This test is sensitive but not specific.[1]
  • Elevated triglyceride levels (hypertriglyceridemia).
  • Elevated uric acid levels (hyperuricemia)
  • Low potassium levels (hypokalemia)
  • Low magnesium levels (hypomagnesemia)
  • Elevated index of red blood cell size; increased mean corpuscular erythrocyte volume (MCV)



2010 AASLD/ACG Alcoholic Liver Disease Guidelines (DO NOT EDIT)[2]

Laboratory Tests : Guidelines (DO NOT EDIT)[2]

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) "

References

  1. 1.0 1.1 Marsano LS, Mendez C, Hill D, Barve S, McClain CJ (2003). "Diagnosis and treatment of alcoholic liver disease and its complications". Alcohol Res Health. 27 (3): 247–56. PMID 15535453.
  2. 2.0 2.1 "www.aasld.org" (PDF). Retrieved 2012-10-27.

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