Laboratory evaluation of liver disease.
With respect to liver disease, the primary function of the laboratory is to identify its presence. Tests are not available that permit a specific diagnosis and an accurate prognosis. Several tests should be present in a minimum data base that can help identify hepatobiliary disease. They are ALT, SAP, total serum bilirubin, urine bilirubin, cholesterol, albumin, BUN, glucose, red cell morphology, and urine sediment. It is sometimes possible to tentatively identify whether a disease is primarily hepatocellular or biliary from the pattern of changes that occur in these tests. In addition, an estimate of the severity is sometimes possible when abnormal values are extreme. The keys are to avoid overinterpretation, use serial evaluations, and rely on a liver biopsy when definitive answers are needed. If liver disease is suspected but there are only marginal changes in the routine tests, the more sensitive tests of function, BSP retention and ammonia tolerance, are warranted. In the future, as more knowledge is gained about the responses of ARG, GGT, and ICG retention to naturally occurring diseases, these tests may join or replace some of those currently used. Also, as the ability to accurately and economically measure the various bile acids improves, a sensitive, yet noninvasive, method to detect and define modest changes in hepatobiliary function may result.
D000641:Ammonia / Q000378:metabolism; D000818:Animals; D001647:Bile Acids and Salts / Q000378:metabolism; D001654:Bile Pigments / Q000652:urine; D001663:Bilirubin / Q000378:metabolism; D001798:Blood Proteins / Q000032:analysis; D002371:Cat Diseases / Q000175:diagnosis* / Q000378:metabolism; D002415:Cats; D002784:Cholesterol / Q000378:metabolism; D004283:Dog Diseases / Q000175:diagnosis* / Q000378:metabolism; D004285:Dogs; D008099:Liver / Q000201:enzymology; D008107:Liver Diseases / Q000175:diagnosis / Q000378:metabolism / Q000662:veterinary*; D008111:Liver Function Tests / Q000662:veterinary
D001647:Bile Acids and Salts; D001654:Bile Pigments; D001798:Blood Proteins; D000641:Ammonia; D002784:Cholesterol; D001663:Bilirubin