Ascending cholangitis laboratory findings: Difference between revisions

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{{Ascending cholangitis}}
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{{CMG}}; {{AE}} {{AHS}}
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== Overview[edit | edit source] ==
== Overview==
Certain laboratory tests may be helpful in the [[diagnosis]] of [[cholangitis]]. Some commonly conducted tests include [[complete blood count]], [[basic metabolic panel]], [[liver function tests]], [[blood culture]], and other body fluid cultures. Findings include [[Leucocytosis,|leukocytosis,]] elevated liver enzymes, elevated [[C-reactive protein|CRP]] and [[Erythrocyte sedimentation rate|ESR]], abnormal serum electrolytes. Positive bile and blood cultures may also be seen  
Certain laboratory tests may be helpful in the [[diagnosis]] of [[cholangitis]]. Some commonly conducted tests include [[complete blood count]], [[basic metabolic panel]], [[liver function tests]], [[blood culture]], and other body fluid cultures. Findings include [[Leucocytosis,|leukocytosis,]] elevated liver enzymes, elevated [[C-reactive protein|CRP]] and [[Erythrocyte sedimentation rate|ESR]], abnormal serum electrolytes. Positive bile and blood cultures may also be seen  


== Laboratory Findings[edit | edit source] ==
== Laboratory Findings ==
Laboratory findings consistent with the diagnosis of ascending cholangitis include<ref name="pmid172522972">{{cite journal| author=Wada K, Takada T, Kawarada Y, Nimura Y, Miura F, Yoshida M et al.| title=Diagnostic criteria and severity assessment of acute cholangitis: Tokyo Guidelines. | journal=J Hepatobiliary Pancreat Surg | year= 2007 | volume= 14 | issue= 1 | pages= 52-8 | pmid=17252297 | doi=10.1007/s00534-006-1156-7 | pmc=2784515 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17252297  }}</ref>:
Laboratory findings consistent with the diagnosis of ascending cholangitis include<ref name="pmid172522972">{{cite journal| author=Wada K, Takada T, Kawarada Y, Nimura Y, Miura F, Yoshida M et al.| title=Diagnostic criteria and severity assessment of acute cholangitis: Tokyo Guidelines. | journal=J Hepatobiliary Pancreat Surg | year= 2007 | volume= 14 | issue= 1 | pages= 52-8 | pmid=17252297 | doi=10.1007/s00534-006-1156-7 | pmc=2784515 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17252297  }}</ref>:
* '''Complete blood count'''
* '''Complete blood count'''
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** Elevated [[gamma-glutamyl transpeptidase]] ([[GGT]])
** Elevated [[gamma-glutamyl transpeptidase]] ([[GGT]])
** Elevated conjugated (direct) [[bilirubin]] (predominantly incase of obstruction)
** Elevated conjugated (direct) [[bilirubin]] (predominantly incase of obstruction)
** Elevated [[aminotransferases]] (as high as 1000 IU/L), reflecting [[hepatocytes]] injury and microabscess formation - Liver abscess may be suspected in such cases.
** Elevated [[aminotransferases]] (as high as 1000 IU/L), reflecting [[hepatocytes]] injury and microabscess formation - Liver abscess may be suspected in such cases
* '''Serum [[amylase]]'''<ref>Liu, Chi-Leung. & Fan, Sheung-Tat. (2001), ''Surgical Treatment: Evidence-Based and Problem-Oriented.'', Munich, Germany: Zuckschwerdt Verlag</ref>
* '''Serum [[amylase]]'''<ref>Liu, Chi-Leung. & Fan, Sheung-Tat. (2001), ''Surgical Treatment: Evidence-Based and Problem-Oriented.'', Munich, Germany: Zuckschwerdt Verlag</ref>
** May be elevated in one third of the patients
** May be elevated in one third of the patients
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* '''ESR and CRP'''<ref name="pmid17127193">{{cite journal| author=van Erpecum KJ| title=Gallstone disease. Complications of bile-duct stones: Acute cholangitis and pancreatitis. | journal=Best Pract Res Clin Gastroenterol | year= 2006 | volume= 20 | issue= 6 | pages= 1139-52 | pmid=17127193 | doi=10.1016/j.bpg.2006.03.012 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17127193  }}</ref>
* '''ESR and CRP'''<ref name="pmid17127193">{{cite journal| author=van Erpecum KJ| title=Gallstone disease. Complications of bile-duct stones: Acute cholangitis and pancreatitis. | journal=Best Pract Res Clin Gastroenterol | year= 2006 | volume= 20 | issue= 6 | pages= 1139-52 | pmid=17127193 | doi=10.1016/j.bpg.2006.03.012 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17127193  }}</ref>
** Usually elevated
** Usually elevated
* '''Creatinine''' -
* '''Creatinine'''  
** May be elevated more than or equal to 1.5mg/dl
** May be elevated more than or equal to 1.5mg/dl
* '''Blood culture'''
* '''Blood culture'''

Latest revision as of 23:10, 15 October 2018

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

Overview

Certain laboratory tests may be helpful in the diagnosis of cholangitis. Some commonly conducted tests include complete blood count, basic metabolic panel, liver function tests, blood culture, and other body fluid cultures. Findings include leukocytosis, elevated liver enzymes, elevated CRP and ESR, abnormal serum electrolytes. Positive bile and blood cultures may also be seen

Laboratory Findings

Laboratory findings consistent with the diagnosis of ascending cholangitis include[1]:

References

  1. Wada K, Takada T, Kawarada Y, Nimura Y, Miura F, Yoshida M; et al. (2007). "Diagnostic criteria and severity assessment of acute cholangitis: Tokyo Guidelines". J Hepatobiliary Pancreat Surg. 14 (1): 52–8. doi:10.1007/s00534-006-1156-7. PMC 2784515. PMID 17252297.
  2. Cameron, John L. & Cameron, Andrew M. (2014), Current Surgical Therapy: Expert Consult, Philadelphia, PA: Elsevier, Inc.
  3. Liu, Chi-Leung. & Fan, Sheung-Tat. (2001), Surgical Treatment: Evidence-Based and Problem-Oriented., Munich, Germany: Zuckschwerdt Verlag
  4. van Erpecum KJ (2006). "Gallstone disease. Complications of bile-duct stones: Acute cholangitis and pancreatitis". Best Pract Res Clin Gastroenterol. 20 (6): 1139–52. doi:10.1016/j.bpg.2006.03.012. PMID 17127193.
  5. Lipsett PA, Pitt HA (1990). "Acute cholangitis". Surg Clin North Am. 70 (6): 1297–312. PMID 2247816.