title: Evaluation of abnormal liver tests.
abstract: Serum liver tests are important but often problematic in evaluating patients with and without symptoms of hepatic disease. The common term "liver function tests" is misleading because most tests used in clinical practice measure hepatocellular damage not function. True liver function tests are those that measure synthesis of proteins made by the liver (albumin, clotting factors) or the liver's capacity to metabolize drugs. A commonly ordered panel of automated tests includes bilirubin, aminotransferases, alkaline phosphatase, and gamma-glutamyl transpeptidase. This article reviews patterns of elevated enzyme values encountered in liver diseases and their diagnostic limitations and provides an algorithm for evaluating abnormal liver test results.
authors.affiliation: Division of Gastroenterology and Hepatology, University of Arkansas for Medical Sciences and Central Arkansas Veterans Healthcare System, Little Rock, Arkansas, USA.
authors.forename: F A
authors.initials: FA
authors.lastname: Rochling
mesh_terms: D000410:Alanine Transaminase / Q000097:blood; D000418:Albumins / Q000378:metabolism; D000469:Alkaline Phosphatase / Q000097:blood; D001663:Bilirubin / Q000097:blood; D006801:Humans; D007136:Immunoglobulins / Q000097:blood; D008107:Liver Diseases / Q000097:blood* / Q000201:enzymology; D008111:Liver Function Tests; D008875:Middle Aged; D011517:Prothrombin Time; D005723:gamma-Glutamyltransferase / Q000097:blood
chemical_list: D000418:Albumins; D007136:Immunoglobulins; D005723:gamma-Glutamyltransferase; D000410:Alanine Transaminase; D000469:Alkaline Phosphatase; D001663:Bilirubin