What does a liver function test show? How can it help diagnose alcoholic hepatitis? Discover the key details about this essential medical test and its role in identifying liver damage and disease.

Understanding Liver Function Tests

A liver function test, also known as an LFT, is a blood test that provides valuable insights into the overall health and performance of the liver. The liver is a vital organ responsible for numerous critical functions, including filtering blood, processing waste, producing essential proteins, and aiding in digestion. By analyzing specific enzymes, proteins, and other substances in the blood, liver function tests can help healthcare providers identify potential liver damage or dysfunction.

Assessing Liver Function: Key Measurements

Liver function tests typically measure the levels of several key substances in the blood, including:

• Alanine Transaminase (ALT) and Aspartate Transaminase (AST) – Enzymes found primarily in the liver, which can indicate liver damage if present in high levels.
• Alkaline Phosphatase (ALP) and Gamma-Glutamyl Transpeptidase (GGT) – Enzymes that can signal bile duct blockage or liver disease.
• Albumin and Globulin – Proteins produced by the liver that can provide insights into liver function and overall health.
• Bilirubin – A substance created from the breakdown of red blood cells, which can build up in the body if the liver is not functioning properly.
• Prothrombin Time (PT) – A measure of how long it takes the blood to clot, which can indicate liver damage or impaired blood-clotting ability.

Interpreting Liver Function Test Results

Abnormal liver function test results can indicate a variety of underlying conditions, including:

1. Alcoholic Hepatitis – Inflammation of the liver caused by excessive alcohol consumption, which can lead to liver damage and scarring.
2. Viral Hepatitis – Liver inflammation caused by viruses such as hepatitis B or C, which can also result in liver damage.
3. Fatty Liver Disease – Accumulation of fat in the liver, often linked to conditions like obesity, diabetes, or high cholesterol.
4. Liver Cancer – Abnormal growth of liver cells, which can disrupt normal liver function.
5. Cirrhosis – Scarring and hardening of the liver, which can impair its ability to perform critical functions.

Diagnosing Alcoholic Hepatitis

When it comes to diagnosing alcoholic hepatitis, liver function tests play a crucial role. Elevated levels of AST and ALT enzymes, along with a high AST/ALT ratio, are often indicative of alcoholic liver disease. Additionally, abnormal bilirubin and albumin levels, as well as prolonged prothrombin time, can further support a diagnosis of alcoholic hepatitis.

Preparing for a Liver Function Test

Typically, no special preparation is required for a liver function test. However, your healthcare provider may provide specific instructions, such as fasting or avoiding certain medications, to ensure the accuracy of the test results. It’s important to follow these instructions carefully to obtain the most reliable information about your liver’s health.

Discussing Your Liver Function Test Results

If your liver function test results indicate any abnormalities, it’s essential to discuss them with your healthcare provider. They can help you understand the potential causes, the severity of the issue, and the appropriate next steps for further evaluation and treatment, if necessary.

Monitoring Liver Health

Regular liver function tests can be a valuable tool for monitoring the health of your liver, especially if you have a history of liver disease, heavy alcohol consumption, or other risk factors. By staying informed about your liver’s performance, you can work with your healthcare provider to proactively address any concerns and maintain optimal liver function.

Remember, understanding your liver function test results is crucial for maintaining overall health and well-being. If you have any questions or concerns, don’t hesitate to consult with your healthcare provider for personalized guidance and support.

Liver Function Tests

Overview

What is a liver function test?

A liver function test is a blood test in which the blood is examined in a laboratory to check for liver damage and the overall health of the liver. The levels of certain substances in the blood can help show if the liver is working properly.

What does the liver do?

The liver’s functions include:

• Filtering blood from the digestive tract
• Storing energy
• Processing waste products
• Removing poisons
• Producing proteins that help blood clot
• Producing glucose (blood sugar)
• Aiding in digestion

Test Details

What do liver function tests check?

A liver function test checks the enzyme and protein levels in the blood. Enzymes found in the liver and other parts of the body include alanine transaminase (ALT), aspartate transaminase (AST), alkaline phosphatase (ALP), and gamma-glutamyl transpeptidase (GGT). High levels of these enzymes could mean damage to the liver or bile duct.

The liver also produces proteins, including albumin, globulin, and prothrombin. Low levels of these proteins could be a sign of liver damage. A prothrombin time test shows how long it takes for blood to clot.

A liver function test also measures platelet counts and glucose levels. (Platelets help the blood to clot in order to stop bleeding.)

The liver function test also measures bilirubin levels. Bilirubin is a fluid created from the breaking down of red blood cells. If the liver is damaged, bilirubin can leak out of the liver. This can cause the disease jaundice, in which the skin or eyes turn yellow. High bilirubin levels can also make urine darker in color.

What should I do to prepare for a liver function test?

Your healthcare provider may ask you not to eat, drink, or take certain medications in order to avoid affecting the test results.

Results and Follow-Up

What are normal laboratory ranges for liver function tests?

The laboratory that completes your test may use normal ranges that differ slightly. Check with your healthcare provider for the details.

What can cause abnormal results in a liver function test?

Several conditions can cause abnormal results in a liver function test, including:

• Alcoholism
• Diabetes mellitus
• Obesity
• Hepatitis B
• Hepatitis C
• Side effects of medications
• Acute hepatitis A
• Celiac disease (an autoimmune disease in which the person must avoid foods that contain gluten)
• Liver cancer
• Other illnesses and conditions

Talk with your doctor if you have any questions about your liver function test results.

LFT test – liver function blood test

On this page

What is being tested?

Liver function tests (also called LFTs) are blood tests that can provide information about how the liver is working. They test the levels of a number of proteins and enzymes that are either produced by liver cells or released into the blood when liver cells are damaged.

The liver is a large organ in the upper right of the abdomen and is necessary for many different functions. For example, it processes drugs and alcohol, filters toxic chemicals, stores vitamins and minerals, and makes bile, proteins and enzymes.

LFTs examine proteins, enzymes, and other substances that indicate how well the liver is working. They can show if there is damage to liver cells or a blockage to blood flow through the liver.

Why would I need this test?

Doctors often request these tests for people who:

• have liver disease or damage
• are, or might be, infected with hepatitis viruses
• are heavy drinkers
• have a family history of liver disease
• take drugs that can damage the liver

Your doctor might order LFTs if you have:

How to prepare for liver function test?

No preparation is needed for this test.

Understanding your results

Each of the LFTs gives different information about liver function. The results do not indicate a specific condition, but their combined results can indicate patterns usually seen with liver disease or damage.

If your liver function tests are abnormal, further testing might be necessary to work out what is causing the liver damage and/or disease.

Some LFTs can be affected by conditions in the bones or elsewhere in the body. It is also possible that some LFT results can be mildly abnormal when there is no problem at all.

You should discuss the results with your doctor to see what they mean in your particular situation.

More information

Lab Tests Online has more information about liver function tests.

About blood testing

Visit healthdirect Guide to blood testing to learn more about blood tests in general, including information about:

• what to consider before having a blood test
• what happens during a blood test
• results accuracy
• blood tests cost

What is a liver function test?

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A liver function test, also called an LFT, is a blood test that measures enzymes and proteins in the blood. Enzyme tests show the extent of damage to a liver, while proteins show how well a liver is performing. An LFT is a diagnostic tool used to detect whether a person’s liver is damaged, and can also be a screening tool for measuring the severity and type of liver disease.

Liver function is measured with a series of blood tests, called a panel. In a standard liver panel, liver enzyme tests measure levels of alanine transaminase (ALT), aspartate transaminase (AST), alkaline phosphatase (ALP), and gamma-glutamyl transpeptidase (GGT). Increased levels of ALT and AST can be a sign of liver damage, while increased levels of ALP and GGT can be a sign of bile duct or liver damage.

Liver protein tests measure total protein, which consists of measuring levels of globulin, prothrombin and albumin; low levels of these proteins in a person’s blood can indicate liver damage. Globulin aids the immune system with fighting infections, prothrombin aids in blood clotting, and albumin levels show whether the liver is producing a normal level of proteins.

A liver panel will also measure bilirubin levels in a person’s body to determine the severity of liver damage. During advanced stages of liver damage, bilirubin can leak out of the liver and cause jaundice, turning the urine dark and eyes yellow.

Before an LFT, a physician will advise their patient not to consume certain foods or drinks that could potentially affect the results. These include over-the-counter and herbal supplements. The results of an LFT can vary depending on factors such as age and gender.

Additional information may be found at these websites:

http://www.nlm.nih.gov/medlineplus/ency/article/003436. htm

http://www.mayoclinic.org/tests-procedures/liver-function-tests/basics/definition/prc-20012602

http://www.liverfoundation.org/abouttheliver/info/liverfunctiontests/

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Liver Function Tests – an overview

Liver Function Test Abnormalities: Clinicopathologic Correlates

LFTs are usually obtained incidentally as part of a blood chemistry panel. In SLE, nonspecific liver enzyme elevations occur frequently; however, the significance of such abnormalities has been a matter of controversy, and several studies have tried to address their importance (Table 37. 1). LFT abnormalities in SLE are the result of the administration of medications such as NSAIDs or methotrexate, or they are elevated because of increased muscle enzyme levels. It is thought that SLE patients have high levels of systemic oxidative stress, which makes them more susceptible to such drug-induced liver injury. Rarely, acute toxic hepatitis with 10-fold elevation in liver enzymes may occur with hydroxychlorquine.¹²⁴

The association of liver abnormalities in SLE with disease activity remains unclear. In a longitudinal study of 435 SLE patients¹¹⁹ ≥2-fold elevation of AST or ALT was associated with higher SLEDAI (7.8 ± 0.7) relative to those without (5.8 ± 0.3; p = 0.0025). Presence of antismooth muscle antibodies, anti-DNA antibodies, hypocomplementemia, proteinuria, leukopenia, thrombocytopenia, and antiphospholipid syndrome was increased in those with LD. An absence of LD was noted among SLE patients receiving rapamycin (relative to azathioprine, cyclosporine, or cyclophosphamide) and N-acetylcysteine. LFTs were normalized, and SLEDAI was diminished with increased prednisone use in 76/90 LD patients over 12.1 ± 2.6 months. Miller and colleagues¹¹⁶ undertook a prospective study in 260 patients with SLE and 100 control subjects for 12 months. Of the 60 patients with SLE and abnormal liver function testing, 41 were traced to an identifiable cause (e.g., aspirin in 27 patients, alcohol in 6 patients, other causes in 7 patients). Thus they found a high incidence of subclinical LD; only 2% of patients had clinical LD. Moreover, in 12 of 15 patients with elevated transaminase levels, changes in serum ALT corresponded to active lupus. Petri and colleagues¹³² reported an association between elevated liver enzymes with disease activity, among 216 SLE patients with abnormal LFTs over 1717 visits. On the other hand, the same authors reported that severe LD can be present in patients with SLE with only minimal laboratory abnormalities consistent with active lupus. In another study elevations in LFTs were associated with disease activity and liver membrane autoantibodies. ¹³³

Tsuji and colleagues¹³⁴ reviewed the records of hospitalized patients with lupus over a decade and found 73 patients with elevated transaminases. Of these patients, 43 (58.9%) did not have an identifiable cause of elevated transaminases and was attributed to active SLE. Of the identifiable cause of elevated liver enzymes, seven (9.6%) patients were identified to have hemophagocytic syndrome on the basis of a significant elevation of serum ferritin levels. This group of patients also had the highest elevation in liver enzymes. Viral infections were not ruled out as the cause of hemophagocytic syndrome in this retrospective review.

van Hoek¹³⁵ reviewed the causes of elevated liver enzymes in SLE and found that medications such as NSAIDs, aspirin, and azathioprine were the most common causes. LFT abnormalities may result from nonliver-related causes such as unconjugated hyperbilirubinemia, hemolysis, or hepatitis, resulting from immunologic, infectious, or drug-related causes. Takahashi and colleagues¹³¹ reported on 206 SLE patients, 123 (59.7%) of which had liver dysfunction. The causes of liver dysfunction were as follows: drug induced (30.9%), SLE induced (28.5%), fatty liver (17.9%), autoimmune hepatitis (AIH) (4.9%), primary biliary cirrhosis (PBC) (2.4%), cholangitis (1.6%), alcohol (1.6%), and viral hepatitis (0.8%).

Table 37.1 summarizes the important studies that reported pathologic findings of liver involvement in SLE.^120,125-131 Based on the studies in Table 37.1, fatty liver is very common in SLE. Fatty livers are usually associated with corticosteroid therapy. Matsumoto and colleagues¹²⁰ published their findings on 73 liver biopsies and found that fatty liver was identified in 72% of the cases. Several additional reports in the literature have commented on the presence of nodular regeneration and hyperplasia in SLE. The patients in these reports had normal LFT results. This underdiagnosed finding could be secondary to steroid or danazol administration. Concentric membranous bodies in hepatocytes are found in hepatomas but are occasionally seen in lupus, and they reflect increased protein synthesis during regeneration. End-stage LD is not common in SLE unless accompanied by other diseases such as nonalcoholic fatty LD, AIH, or viral hepatitis.

Another rare finding in lupus is peliosis hepatis. In this condition, blood-filled spaces occur in the liver from diverse causes including injury from drugs and infections on the flow of blood from the sinusoids to the centrilobular veins. Langlet¹³⁶ reported on three patients associated with lupus that improved with immunosuppressive treatment.

In summary, most patients with SLE and elevated LFTs have liver biopsy specimens that reveal nodules, mild fatty changes, or mild fibrosis. Rarely, features of chronic active hepatitis are found.

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Tests for Liver Cancer

Some liver cancers can be found by testing people at high risk who don’t have symptoms (screening), but most liver cancers are found because they are causing symptoms. If you have possible signs or symptoms of liver cancer, see your doctor, who will examine you and may order some tests.

Medical history and physical exam

Your doctor will ask about your medical history to learn more about your symptoms and possible risk factors. Your doctor will also examine you to look for signs of liver cancer and other health problems, probably paying special attention to your abdomen and checking your skin and the whites of your eyes looking for jaundice (a yellowish color).

If symptoms and/or the results of the physical exam suggest you might have liver cancer, more tests will probably be done. These might include imaging tests, lab tests, and/or biopsies of liver tissue .

Imaging tests

Imaging tests use x-rays, magnetic fields, or sound waves to create pictures of the inside of your body. Imaging tests maybe done for a number of reasons both before and after a diagnosis of liver cancer, including:

• To help find suspicious areas that might be cancer
• To help a doctor guide a biopsy needle into a suspicious area to take a sample
• To learn how far cancer might have spread
• To help guide certain treatments in the liver
• To help determine if treatment is working
• To look for a possible signs of cancer coming back after treatment

Ultrasound

Ultrasound is often the first test used to look at the liver. It uses sound waves to create an image on a computer screen. This test can show tumors growing in the liver, which then can be tested for cancer, if needed.

Computed tomography (CT)

The CT scan is an x-ray test that makes detailed images of your body. A CT scan of the abdomen can help find many types of liver tumors. It can give specific information about the size, shape, and location of any tumors in the liver or elsewhere in the abdomen, as well as nearby blood vessels. CT scans can also be used to guide a biopsy needle precisely into a suspected tumor (called a CT-guided needle biopsy). If you are found to have liver cancer, a CT of your chest may also be done to look for possible cancer spread to the lungs.

Magnetic resonance imaging (MRI)

Like CT scans, MRI scans provide detailed images of soft tissues in the body. But MRI scans use radio waves and strong magnets instead of x-rays. MRI scans can be very helpful in looking at liver tumors. Sometimes they can tell a benign tumor from a malignant one. They can also be used to look at blood vessels in and around the liver to see any blockages, and can help show if liver cancer has spread to other parts of the body.

Angiography

An angiogram is an x-ray test that looks at blood vessels. Contrast medium, or dye, is injected into an artery to outline blood vessels while x-ray images are taken.

Angiography can be used to show the arteries that supply blood to a liver cancer, which can help doctors decide if a cancer can be removed and to help plan the operation. It can also be used to help guide some types of non-surgical treatment, such as embolization (see Embolization Therapy for Liver Cancer).

Angiography can be uncomfortable because a small catheter (a flexible hollow tube) must be put into the artery leading to the liver to inject the dye. Usually the catheter is put into an artery in your groin and eased up into the liver artery. You have to stay very still while the catheter is in place. A local anesthetic is often used to numb the area before inserting the catheter. Then the dye is injected quickly to outline all the vessels while the x-rays are being taken.

Angiography can also be done with a CT scanner (CT angiography) or an MRI scanner (MR angiography). These techniques are often used instead of x-ray angiography because they can give information about the blood vessels in the liver without the need for a catheter in the groin. You will still need an IV line in your arm so that a contrast dye can be injected into the blood during the test.

Bone scan

A bone scan can help look for cancer that has spread (metastasized) to bones. Doctors don’t usually order this test for people with liver cancer unless you have symptoms such as bone pain, or if there’s a chance you may qualify for a liver transplant to treat your cancer.

Other tests and procedures

Other types of tests may be done if your doctor thinks you might have liver cancer but the imaging results aren’t certain.

Biopsy

A biopsy is the removal of a sample of tissue to see if it is cancer. Sometimes, the only way to be sure that liver cancer is present is to take a biopsy and look at it in the pathology lab. But in some cases, doctors can be fairly certain that a person has liver cancer based on the results of imaging tests such as CT and MRI scans. In these cases, a biopsy may not be needed.

Doctors are often concerned that sticking a needle into the tumor or otherwise disturbing it without completely removing it might help cancer cells spread along the needle’s path. This is a major concern if surgery or a liver transplant might be an option to try to cure the cancer, as any spread of the cancer might make the person ineligible for a transplant. That is why some experts recommend that patients who could be transplant candidates only have biopsies done at the center where the transplant will be done.

If a biopsy is needed, it can be done in several ways.

Needle biopsy: A hollow needle is placed through the skin in the abdomen and into the liver. The skin is first numbed with local anesthesia before the needle is placed. This type of biopsy is typically done with the help of an ultrasound or CT scan to guie the needle.

Laparoscopic biopsy: Biopsy specimens can also be taken during laparoscopy. This lets the doctor see the surface of the liver and take samples of abnormal-appearing areas.

Surgical biopsy: An incisional biopsy (removing a piece of the tumor) or an excisional biopsy (removing the entire tumor and some surrounding normal liver tissue) can be done with surgery.

For more information about biopsies and how they are tested, see Testing Biopsy and Cytology Specimens for Cancer.

Lab tests

Your doctor could order lab tests for a number of reasons:

• To help diagnose liver cancer
• To help determine what might have caused your liver cancer
• To learn how well your liver is working, which can affect what treatments you can have
• To get an idea of your general health and how well your other organs are working, which also could affect what treatments you can have
• To see how well treatment is working
• To look for signs that the cancer has come back after treatment

Alpha-fetoprotein blood (AFP) test

AFP is a protein that can be found in high levels in adults with liver disease, liver cancer, who are pregnant, or other cancers.

If AFP levels are very high in someone with a liver tumor, it can be a sign that liver cancer is present. But liver cancer isn’t the only reason for high AFP levels. Many patients with early liver cancer have normal levels of AFP, so high AFP levels aren’t very helpful in determining if a liver mass might be cancer.

This test, however, is sometimes useful in people already diagnosed with liver cancer. The AFP level can help determine treatment options. During treatment, the test can be used to give an idea of how well it is working, as the AFP level should go down if treatment is effective. The test can also be used after treatment, to look for possible signs that the cancer has come back (recurred).

Other blood tests

Tests for viral hepatitis: Your doctor might order blood tests to check for hepatitis B and C.

Liver function tests (LFTs): Because liver cancer often develops in livers already damaged by hepatitis and/or cirrhosis, doctors need to know the condition of your liver before starting your treatment. If the part of your liver not affected by cancer isn’t working well, you might not be able to have surgery to try to cure the cancer, as the surgery might require removal of a large part of your liver. Other treatment options such as certain targeted therapy or chemotherapy may also not be good choices if your liver is not working well.

Blood clotting tests: The liver also makes proteins that help blood clot when you bleed. A damaged liver might not make enough of these clotting factors, which could increase your risk of bleeding. Your doctor may order blood tests to help measure this risk.

Kidney function tests: Tests of blood urea nitrogen (BUN) and creatinine levels are often done to assess how well your kidneys are working.

Complete blood count (CBC): This test measures levels of red blood cells (which carry oxygen throughout your body), white blood cells (which fight infections), and platelets (which help the blood clot). It gives an idea of how well the bone marrow (where new blood cells are made) is functioning.

Blood chemistry tests and other tests: Blood chemistry tests check the levels of a number of substances in the blood, some of which might be affected by liver cancer. For example, liver cancer can raise blood levels of calcium, while blood glucose levels may fall. Liver cancer can also sometimes raise cholesterol levels, so this may be checked as well.

For more information about tests see Exams and Tests for Cancer.

Abnormal liver function tests | Nuffield Health

These include:

• Weakness, fatigue
• Loss of appetite
• Nausea and vomiting
• Abdominal swelling and/or pain
• Jaundice
• Dark urine, light coloured stool
• Itching

A liver panel is a group of tests that are performed together to detect, evaluate, and monitor liver disease or damage. The liver is one of the largest organs in the body and metabolises and detoxifies drugs and substances that are harmful to the body. It makes blood clotting factors, proteins, and enzymes, helps maintain hormone balances, and stores vitamins and minerals. Bile is transported through ducts directly or via the gall bladder to the small intestine to help digest fats.

The liver can be subject to a variety of diseases and infections causing acute or chronic damage, inflammation, scarring, bile duct obstructions, clotting abnormalities, and liver dysfunction. A significant amount of liver damage may be present before symptoms such as jaundice, dark urine, light-coloured stools, nausea, fatigue, diarrhoea, and unexplained weight loss or gain emerge. Early detection is essential in order to minimise damage and preserve liver function.

The basic Liver Function Test Profile measures enzymes, proteins, and substances that are produced or excreted by the liver and are affected by liver injury. Some are released by damaged liver cells and some reflect a decrease in the liver’s ability to perform one or more of its functions. When performed together, these tests give a snapshot of the health of the liver, an indication of the potential severity of any liver injury, change in liver status over time, and a starting place for further diagnostic testing.

The panel consists of several tests that are run at the same time on a blood sample.

• Total Protein – includes albumin and all other proteins in blood, including antibodies made to help fight off infections. Total protein is typically normal with liver disease
• Albumin – the main protein made by the liver indicates whether the liver is making an adequate amount of this protein. Often normal in liver disease but can be low due to decreased production
• Bilirubin – is a product of normal red blood cell breakdown. Bilirubin is increased when too much is being produced or less is being removed, due to bile duct obstructions, or impaired bilirubin processing
• Aspartate aminotransferase (AST) – an enzyme found in the liver, the heart and other muscles in the body. A very high level of AST is frequently seen with acute Hepatitis and may be normal to moderately increased with chronic Hepatitis. In those with blocked bile ducts, cirrhosis, and liver cancer, AST concentrations may be moderately increased or close to normal. When liver damage is due to alcohol, AST often increases much more than ALT (this is a pattern seen with few other liver diseases). AST is also increased after heart attacks and with muscle injury
• Alanine aminotransferase (ALT) – an enzyme mainly found in the liver; the best test for detecting Hepatitis. Very high levels of ALT are frequently seen with acute Hepatitis with moderate increases in chronic Hepatitis. People with blocked bile ducts, cirrhosis, and liver cancer may have ALT concentrations that are only moderately elevated or close to normal
• Alkaline phosphatase (ALP) – an enzyme related to the bile ducts; often increased when they are blocked when ALP may be significantly increased. Also raised in, liver cancer, and bone disease
• Gamma-glutamyl transferase (GGT) – another enzyme found mainly in liver cells and is useful to help determine the cause of an elevated ALP. Both ALP and GGT are elevated in bile duct and liver disease, but only ALP will be elevated in bone disease. Increased GGT levels are also seen with alcohol consumption and with conditions, such as congestive heart failure
• Coagulation Screen (INR & APTT) – the liver produces proteins involved in the clotting (coagulation) of blood and, if abnormal, may indicate liver damage. Prolonged or increased coagulation can be seen with liver disease, vitamin K deficiency, and with coagulation factor deficiencies

A liver panel may be used to screen a person for liver damage, especially someone who has a condition, or who is taking a drug that may affect the liver. A Liver Investigation Profile and Full Liver Screen includes the liver panel as well as additional tests that relate to liver metabolism and function or have toxic effects on the liver. e.g. Alpha-Antitrypsin, Caeruloplasmin, Ferritin, CRP, Viral Hepatitis, Auto antibodies, vitamin D and Thyroid test.

Source: Nuffield Health Pathology Test Profiles published August 2012

Laboratory examination of liver function

Comprehensive laboratory examination of the liver, allowing to assess its main functions and indicators of protein, carbohydrate, fat and pigment metabolism.

The results of the examination are issued with the interpretation of the doctor .

Synonyms Russian

• Tests to assess liver function
• Screening for liver diseases

Synonyms English

• Laboratory liver panel
• Liver function tests
• Liver check-up

Research method

• Coagulogram No. 1 (prothrombin (according to Quick), INR) – a method for detecting lateral light scattering, determining the percentage by the end point
• Alanine aminotransferase (ALT) – UV kinetic test
• Serum albumin – BCG method (bromcresol green)
• Aspartate Aminotransferase (AST) – UV Kinetic Test
• Gamma-glutamyl transpeptidase (gamma-HT) – kinetic colorimetric method
• Total bilirubin – colorimetric photometric method
• Direct bilirubin – colorimetric photometric method
• Phosphatase, alkaline, total – colorimetric photometric method
• Total cholesterol – colorimetric photometric method
• Indirect bilirubin – colorimetric photometric method
• Bilirubin and its fractions (total, direct and indirect) – colorimetric photometric method

Units

• Coagulogram No. 1 (prothrombin (according to Quick), INR) -% (percent), sec.(seconds)
• Alanine aminotransferase (ALT) – U / L (unit per liter)
• Serum albumin – g / L (grams per liter)
• Aspartate aminotransferase (AST) – U / L (unit per liter)
• Gamma-glutamyl transpeptidase (gamma-HT) – U / L (unit per liter)
• Total bilirubin – μmol / L (micromole per liter)
• Direct bilirubin – μmol / L (micromole per liter)
• Phosphatase alkaline total – U / L (unit per liter)
• Total cholesterol – mmol / l (millimole per liter)
• Indirect bilirubin – μmol / L (micromole per liter)
• Bilirubin and its fractions (total, direct and indirect) – μmol / L (micromole per liter)

What biomaterial can be used for research?

Venous blood.

How to properly prepare for the study?

• Do not eat within 12 hours prior to examination.
• Eliminate physical and emotional stress for 30 minutes before the study.
• Do not smoke within 30 minutes prior to examination.

General information about the study

The liver is the largest gland in the human body. This body has about 5,000 different functions.The basic functions of the liver can be assessed using a comprehensive laboratory test.

1. Synthetic liver function

• Albumin is the main blood protein that performs a transport function and ensures the maintenance of oncotic pressure. When the synthetic function of the liver is impaired, the concentration of this protein, as a rule, decreases. It should be noted that this decrease is observed in severe liver disease, such as fulminant hepatitis and severe liver failure.On the contrary, with torpid or latent liver diseases (hepatitis C, alcoholic hepatitis), the level of total protein may remain within the normal range. In addition, changes in albumin concentration can be observed in many other diseases and conditions, such as starvation, malabsorption, nephrotic syndrome, infectious diseases, etc.
• Prothrombin according to Quick (another name is prothrombin time) and the international normalized ratio (INR, INR) are the main indicators used to assess the external pathway of blood clotting (fibrinogen, prothrombin, factor V, VII and X).The liver is the main source of the synthesis of these factors, and diseases of this organ can be accompanied by a violation of the coagulation mechanism and lead to increased bleeding. However, it should be noted that clinically significant blood coagulation disorders are observed in the late stages of liver disease.
• Cholesterol can be synthesized in almost any cell of the body, however, most of it (up to 25%) is synthesized in the liver, from where this compound enters the systemic circulation as part of very low density lipoproteins (VLDL) or into the gastrointestinal tract as part of bile acids …Hypercholesterolemia is a characteristic feature of hepatic cholestasis observed in cholelithiasis, primary sclerosing cholangitis, viral hepatitis, primary biliary cirrhosis and some other diseases. Hypocholesterolemia is of less clinical significance. Different fractions of cholesterol are associated with different effects on human health. Thus, cholesterol in low-density lipoprotein (LDL-C) is a well-known risk factor for heart disease, while HDL-C is considered one of the protective factors.

2. Exchange function of the liver

• ALT and AST are enzymes necessary for the metabolism of amino acids. Although these enzymes can also be found in many other tissues and organs (heart, skeletal muscles, kidneys, brain, erythrocytes), changes in their concentration in the blood are more often associated with liver diseases, which explains their name – hepatic transaminases. ALT is a more specific marker of liver disease than AST.In viral hepatitis and toxic liver damage, as a rule, the same increase in ALT and AST levels is observed. With alcoholic hepatitis, liver metastases and liver cirrhosis, a more pronounced increase in AST is observed than ALT.
• Alkaline phosphatase, ALP, is another key liver enzyme that catalyzes the transfer of phosphate groups between different molecules. The level of alkaline phosphatase is determined when cholestasis is suspected: the concentration of total alkaline phosphatase is increased in almost 100% of cases of extrahepatic obstruction of the biliary tract.In addition to hepatocytes, alkaline phosphatase is present in bone tissue and intestinal cells, and an increase in total alkaline phosphatase can be observed not only with liver damage, but also with other diseases (bone diseases, myocardial infarction, sarcoidosis).
• Gamma-glutamyl transpeptidase, gamma-HT, is a liver enzyme that catalyzes the transfer of the gamma-glutamyl group of glutathione to other molecules. Currently, gamma-HT is the most sensitive marker of liver disease. An increase in the concentration of gamma-HT can be observed in all liver diseases, but the greatest value of this marker is in the diagnosis of biliary obstruction. With obstruction of the biliary tract, the concentration of gamma-HT increases by 5-30 times. The study of the level of gamma-HT allows us to make sure that the increase in total alkaline phosphatase is caused precisely by liver disease, and not by other causes, primarily diseases of the skeletal system. As a rule, with obstruction of the biliary tract, there is a parallel increase in the level of gamma-HT and total alkaline phosphatase. High levels of gamma-HT are characteristic of metastatic lesions and alcoholic cirrhosis of the liver. In viral hepatitis, there is a moderate increase in the level of gamma-HT (2-5 times).

3. Excretory liver function

• Bilirubin is a pigment formed during the breakdown of hemoglobin and some other heme-containing proteins in the liver, spleen and bone marrow. It is toxic to the nervous system and must be removed from the body in the bile or urine. The excretion of bilirubin is a multi-step process in which the liver plays a major role. There are two main fractions of bilirubin: direct and indirect bilirubin.When bilirubin binds to glucuronic acid, bound bilirubin is formed in the liver. Since this type of bilirubin can be determined directly using a direct laboratory test, it is also called direct bilirubin. Bilirubin that has not been conjugated with glucuronic acid is called unbound. Under laboratory conditions, it is not possible to determine the level of unbound bilirubin: its concentration is calculated based on the concentrations of total and bound bilirubin.For this reason, this type of bilirubin is also called indirect. Total bilirubin consists of both fractions. An increase in the level of bilirubin can be observed in many liver diseases, but the greatest value of this marker lies in the differential diagnosis of jaundice. Hemolytic (suprahepatic) jaundice is characterized by an increase in total and indirect bilirubin. For hepatic jaundice, an increase in both fractions (direct and indirect bilirubin) and total bilirubin is typical. Obstructive (subhepatic) jaundice is characterized by an increase in total and direct bilirubin.

This comprehensive study includes indicators that assess the main functions of the liver. In some situations, however, additional tests may be required. Repeated analyzes are recommended to be performed using the same test systems, that is, in the same laboratory.

What is the research used for?

• For the assessment of liver function and early diagnosis of diseases affecting it.

When is the study scheduled?

• During routine inspection;
• in the presence of symptoms of liver disease, gallbladder and bile ducts: in case of pain or discomfort in the right hypochondrium, nausea, stool disorders, darkening of the urine color, jaundice, edema, increased bleeding, rapid fatigue;
• when observing a patient receiving hepatotoxic drugs for any disease (methotrexate, tetracyclines, amiodarone, valproic acid, salicylates).

What do the results mean?

Reference values ​​

Coagulogram No. 1 (prothrombin (according to Quick), INR)

90 190

1. INR

1. Prothrombin time

Alanine aminotransferase (ALT)

Serum albumin

Aspartate aminotransferase (AST)

Gamma-glutamyl transpeptidase (gamma-GT)

Total bilirubin

Direct bilirubin: 0 – 5 μmol / L.

Phosphatase, alkaline, total

Total cholesterol:

Indirect bilirubin: calculated value.

Reasons for increase / decrease depending on the determined indicator:

What can influence the result?

Reasons depending on the measured indicator:

90,000 Liver tests. Checking the main “filter” of the body: why and what indicators must be monitored

The human liver is not only an irreplaceable main “filter” of the body, but also its main “laboratory”.With the help of its working cells (hepatocytes), this organ performs hundreds of different functions. The liver constantly supplies the blood with many different substances, therefore, even the slightest violation of hepatic function entails changes in the composition of the blood. And if you do blood tests for certain markers, you can get a clear picture of the state of the liver. We will now talk about these analyzes in more detail.

The numbers that describe the composition of the blood are biochemical indicators. Among these indicators there are those, certain changes in which always indicate changes in liver function – namely, function, not structure (changes in structure are monitored by other methods, for example, ultrasound).Therefore, these tests are called “liver function tests” (FPP) or simply “liver function tests” .

When do I need to take liver tests?

If nothing bothers you, you can donate blood for this study once a year, during a routine medical examination. Also, functional liver tests must be examined during pregnancy, before surgical interventions, before and during treatment courses for certain diseases involving the use of potent drugs.

A compulsory liver test is required in the presence of one or more symptoms such as:

• discomfort in the region of the liver , namely on the right, in the region of the lower pair of ribs. These sensations usually manifest as mild pulling pains and / or tingling. They are especially noticeable when laughing, sneezing, coughing, screaming, bending to the side, lifting heavy objects. They can also make themselves felt after eating fatty, fried, spicy or smoked foods;
• enlargement of the liver in size .Any change in the size of the liver can be traced by ultrasound, but sometimes you can notice it yourself – by the “bulging” of the abdomen without gaining body weight. The enlargement of the liver can be especially clearly determined visually in thin people;
• The appearance in the mouth of an unpleasant aftertaste , bitterness with a “copper” tint, dryness, astringent sensation. At the same time, the taste may dull, and the usual food can cause rejection up to vomiting;
• decrease in body weight against the background of asthenic syndrome .This manifestation of “liver problems” is often a consequence of the previous one. Deterioration of taste, rejection of food, nausea – all this leads to a decrease in the amount of food consumed and weight loss. At the same time, irritability, fatigue, and drowsiness may increase – as a consequence of toxic effects from violations of protein (nitrogen) metabolism and energy deficit due to cutting back on the diet. When nitrogen metabolism is severely impaired, the concentration of ammonia in the blood increases and hepatic hyperammonemia develops;
• “jaundice” – yellowing of the skin, eye proteins and mucous membranes, darkening of urine.All this can be accompanied by peeling and itching of the skin, chills, pain in joints and bones.

The last set of symptoms indicates the presence of serious liver disease, including hepatitis.

Where can I get liver function tests?

You can donate blood for liver function tests in the departments of the all-Ukrainian network of laboratories “MedLab”. The laboratory offers the following “liver” packages:

• Package # 970 “Liver tests # 2” – alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase, g-glutamyl transpeptidase, total protein, total bilirubin.
• Package No. 10 “Liver tests” – bilirubin (total, direct, indirect), alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase, total protein, g-glutamyl transpeptidase;
• Package No. 54 “Assessment of the liver condition”, which includes analyzes for protein fractions (albumin, α-1-globulins, α-2-globulins, β-1-globulins, γ-globulins, A / G ratio), thymol test , total protein, lactate dehydrogenase (LDH), alkaline phosphatase, gamma-glutamyl transpeptidase (GGT), alanine aminotransferase (ALT), aspartate aminotransferase (AST), total bilirubin, direct, indirect;

Research results will be ready:

• Package No. 10 “Liver tests” and Package No. 970 “Liver tests No. 2” – within 1 working day.
• Package # 54 “Assessment of liver condition” – within 2 working days.

How do I prepare for a liver function test?

To achieve the most reliable liver function test results, follow these guidelines:

1. Take the test strictly on an empty stomach . The liver is involved in digestion, and the food itself also affects liver performance. Therefore, you cannot eat for at least 8 hours before taking liver tests (all this time, you can also not drink anything other than pure water).In addition, 3 days before delivery, you need to give up spicy and fatty foods.
2. Do not drink alcohol within 3 days prior to analysis . Even a minimal dose of alcohol puts a strong strain on the liver, changes the composition of the blood and its properties (including clotting and some “liver” parameters).
3. Do not smoke for 12 hours prior to analysis . Substances that enter the bloodstream from cigarette smoke can also change the composition of the blood and affect the results of the study.
4. Avoid strenuous activity , including “serious” sports, for the 3 days prior to analysis. By the way, during this period it is recommended to protect yourself not only from physical, but also from psychoemotional overstrain, stress factors, and also to adhere to the correct sleep regimen.
5. If you are taking any medications, stop taking them if possible . Even harmless vitamins are capable of distorting the result of biochemical “liver” analysis.Therefore, ideally, any medication should be canceled at least a week before the delivery of the FPP. If this is not possible, then it is necessary to warn the doctor in advance about the medications that you are taking.

IMPORTANT! Liver tests, like any other analysis, in different laboratories can be performed using different methods, using different equipment and using different units of measurement. Therefore, when a doctor prescribes a second study to assess the effectiveness of treatment, it is necessary to conduct it in the same laboratory , where liver tests were previously donated.

Pass the test for bile acids

Method of determination
Colorimetric photometric

Study material
Blood serum

Home visit available

Online check-in

Synonyms : Study of the level of bile acids in the blood; bile acids in the blood;

Bile Acid Test; Bile Salt Test.

Brief characteristics of the analyte

Bile acids Marker of cholestasis used to assess the state of the hepatobiliary system.

Bile acids are formed in the liver from cholesterol and enter the gallbladder as part of bile, in which they accumulate and concentrate. When eaten, they are excreted in the bile into the intestines, where they emulsify fats, thereby facilitating digestion. In the intestine, 90% of the incoming bile acids are subsequently reabsorbed.

An increased concentration of bile acids on an empty stomach is observed in violation of the outflow of bile. After eating, the level of bile acids only slightly increases in healthy people, but significantly increases in people with various liver diseases, including cirrhosis, hepatitis, cholestasis, alcoholic and drug liver damage, portal vein thrombosis, hepatic vein blockage – Budd-Chiari syndrome, cholangitis , Konovalov-Wilson’s disease, hemochromatosis. Metabolic disorders such as Gilbert, Dubin-Johnson, Crigler-Nayyard syndromes do not cause an increase in serum bile acid levels.The test by itself does not differentiate between different causes of changes in liver function and should always be used in conjunction with other methods of assessing liver function.

The study of the level of bile acids is considered the most useful test in the diagnosis of intrahepatic cholestasis of pregnancy (manifested by itching of the skin, sometimes painful). This rather rare temporary pathological condition is presumably associated with the activation of steroid metabolism during pregnancy and a certain genetic predisposition.It affects about 1% of pregnant women and stops immediately after delivery. The level of bile acids in cholestasis of pregnancy is often increased by 3 or more times (possibly an increase in 10-100 times relative to the usual limits). Fasting bile acid concentrations of more than 40 μmol / L are associated with an increased risk of pregnancy complications. Aminotransferases in this condition can be normal or moderately elevated. The level of alkaline phosphatase is almost always above normal (interpretation is complicated by a possible increase in the concentration of its placental isoenzyme).

For what purpose is the level of bile acids in the blood determined?

Bile acids are used as a marker of the functional state of the liver, as well as in the diagnosis of cholestasis in pregnant women.

The study of bile acids can be used in the control of the liver condition in patients with chronic hepatitis C, including as a marker of the improvement of the liver condition at the histological level in patients with chronic hepatitis C and a sustained response to interferon therapy.

90,000 Cancer diagnosis: why tumor markers “don’t work”

A blood test for tumor markers is one of the most popular tests that people prescribe to themselves “just in case”. Why this should not be done, and what diagnostic methods actually help to detect cancer at an early stage, says EMC oncologist, Ph.D. Gelena Petrovna Gens.

Gelena Petrovna, is it possible to diagnose cancer at an early stage using tumor markers?

Indeed, many patients have a firm belief that tumor cells secrete certain substances that circulate in the blood from the moment the neoplasm begins, and it is enough to periodically take a blood test for tumor markers to make sure that there is no cancer.

There are many materials on the Internet on this topic, which, unfortunately, contain absolutely false statements that by checking blood for tumor markers, it is possible to detect a disease at an early stage.

In fact, the use of tumor markers for reliable detection of cancer has not been shown to be effective in any study; therefore, they cannot be recommended for the primary diagnosis of cancer.

The values ​​of tumor markers do not always correlate with the disease.As an example, I will give a case from my own practice: I recently received treatment for a patient – a young woman who was diagnosed with metastatic breast cancer, while the values ​​of the CA 15.3 tumor marker remained within the normal range.

What causes, other than oncological diseases, can cause an increase in tumor markers?

In diagnostics, there are two criteria by which we evaluate any study – these are sensitivity and specificity. Markers can be highly sensitive but low specific.This suggests that their increase may depend on a number of reasons that are completely unrelated to cancer. For example, the ovarian cancer marker CA 125 can be increased not only in tumors or inflammatory diseases of the ovaries, but, for example, in impaired liver function, inflammatory diseases of the cervix and the uterus itself. Cancer embryonic antigen (CEA) often rises when liver function is impaired. Thus, the values ​​of tumor markers depend on a number of processes, including inflammatory ones, that can occur in the body.

In this case, it so happens that a slight increase in the tumor marker serves as the beginning for the start of a whole series of diagnostic procedures up to such a hazardous study as positron emission tomography (PET / CT), and as it turns out later, this patient did not need these procedures at all.

What are tumor markers used for?

Tumor markers are mainly used to monitor the course of the disease and assess the effectiveness of drug therapy for tumor diseases.In the event that initially, when establishing the diagnosis, an increase in the tumor marker was found in the patient, in the future, with its help, we can track how the treatment is proceeding. Often after surgery or chemotherapy treatment, we see how the level of the marker literally “falls off” from several thousand units to normal values. Its increase in dynamics may indicate that either a relapse of the tumor has occurred, or the remaining, as the doctors say, “residual” tumor has shown resistance to treatment.Along with the results of other studies, this can serve as a signal for doctors that they should think about changing treatment tactics and about further full examination of the patient.

Are there studies that really help detect cancer at an early stage?

There are studies for the detection of certain types of cancer that have been shown to be reliable and effective in large epidemiological studies and are recommended for use in a screening regimen.

For example, the United States Preventive Service Task Force (USPSTF), based on recent clinical trials, recommends low-dose computed tomography for lung cancer screening. Low-dose CT is recommended for people in the 55 to 80 age group who have a 30-year history of smoking or have quit smoking no more than 15 years ago. Today it is the most accurate method for early detection of lung cancer, the effectiveness of which has been confirmed from the point of view of evidence-based medicine.

Neither X-ray examination, let alone fluorography of the chest organs, which were used earlier, can replace low-dose CT, since their resolution allows revealing only large-focal formations, which indicate the late stages of the oncological process.

At the same time, views on some types of screening, which have been massively used for several decades, are being revised today. For example, in the past, doctors recommended that men have a PSA blood test to screen for prostate cancer.But recent studies have shown that PSA levels are not always a reliable basis for initiating diagnostic measures. Therefore, now we recommend taking PSA only after consulting a urologist.

For breast cancer screening, the recommendations remain the same – for women who are not at risk for breast cancer, mammography is mandatory after 50 years of age every two years. With an increased density of breast tissue (occurs in about 40% of women), it is necessary to carry out an ultrasound of the mammary glands in addition to mammography.

Another very common cancer that can be detected by screening is intestinal cancer.

Colonoscopy is recommended for the detection of bowel cancer, which is sufficient to be performed once every five years, starting from the age of 50, in the event that there are no complaints and aggravated heredity for this disease. At the request of the patient, the examination can be carried out under anesthesia and not cause any unpleasant sensations, while it is the most accurate and effective method for diagnosing colorectal cancer.

Today, there are alternative methods: CT colonography, or “virtual colonoscopy”, allows you to examine the colon without the introduction of an endoscope – on a computer tomograph. The method has a high sensitivity: 90% when diagnosing polyps of more than 1 cm with a study duration of about 10 minutes. It can be recommended for those who have previously undergone traditional screening colonoscopy, which did not reveal any abnormalities.

What should young people pay attention to?

Screening that starts at an earlier age is screening for cervical cancer.A smear for oncocytology (PAP test), according to American recommendations, must be taken from the age of 21. In addition, it is necessary to take a test for human papillomavirus (HPV), since long-term carriage of certain oncogenic types of HPV is associated with a high risk of developing cervical cancer. Vaccination of girls and young women against HPV is a reliable method of protection against cervical cancer.

Unfortunately, the incidence of skin cancer and melanoma has been increasing recently.Therefore, it is advisable to show the so-called “moles” and other pigmented formations on the skin to a dermatologist once a year, especially if you are at risk: you have fair skin, there have been cases of skin cancer or melanoma in your family, there have been cases of sunburn, or you are an amateur visit solariums, which, by the way, are prohibited in some countries for visiting under 18 years old. Two or more episodes of skin sunburn have been shown to increase the risk of skin cancer and melanoma.

Is it possible to follow the “moles” yourself?

Specialists have a skeptical attitude towards self-examinations.For example, breast self-examination, which was so promoted in the past, has not been proven to be effective. Now it is considered harmful, because it lulls the vigilance and does not allow diagnostics to be carried out in time. So is the examination of the skin. Better if done by a dermatologist.

Can cancer be inherited?

Fortunately, most cancers are not inherited. Of all cancers, only about 15% are hereditary.A striking example of hereditary cancer is the carriage of mutations in the BRCA 1 and BRCA 2 anti-oncogenes, which is associated with an increased risk of breast cancer and, to a lesser extent, ovarian cancer. Everyone knows the story of Angelina Jolie, whose mother and grandmother died of breast cancer. Such women need to be monitored regularly and undergo breast and ovarian examinations to prevent the development of hereditary cancer.

The remaining 85% of tumors are tumors that arise spontaneously and do not depend on any hereditary predisposition.

However, if several blood relatives in the family suffered from oncological diseases, we say that their children may have a reduced ability to metabolize carcinogenic substances, as well as to repair DNA, that is, to “fix” DNA, to put it simply.

What are the main risk factors for developing cancer?

The main risk factors include work in hazardous industries, smoking, frequent (more than three times a week) and long-term alcohol consumption, daily consumption of red meat, constant consumption of food that has been heat-treated, frozen and sold ready-to-eat. …Such food is poor in fiber, vitamins and other substances that a person needs, which can lead to an increased risk of, for example, breast cancer. Smoking is one of the most common and formidable risk factors – it leads not only to lung cancer, but also cancer of the esophagus, stomach, bladder, head and neck tumors: cancer of the larynx, cancer of the buccal mucosa, cancer of the tongue, etc.

For skin cancer and melanoma, as we have already mentioned, exposure to the sun prior to sunburn is a risk factor.

Long-term use of hormonal drugs, for example, hormone replacement therapy, for more than 5 years and not under the supervision of doctors, can lead to an increased risk of breast cancer and uterine cancer in women, therefore, taking such drugs should be carried out under the strict supervision of a mammologist and gynecologist.

As we mentioned above, viruses, including oncogenic types of HPV virus, which lead to cancer of the genital organs and cancer of the oral cavity, can also be a risk factor.Some non-carcinogenic viruses can also be risk factors. For example, hepatitis B and C viruses: they do not directly cause liver cancer, but lead to chronic inflammatory liver disease – hepatitis, and after 15 years, a patient with chronic hepatitis B and C may develop hepatocellular cancer.

When to consult a doctor?

If there are risk factors or the person feels anxious, it is best to consult an oncologist.What you should definitely not do is to appoint examinations to yourself. You can get a ton of false positive and false negative results that can complicate your life and can lead to stress, unnecessary diagnostic procedures and interventions. Of course, if alarming symptoms suddenly appear, then it is imperative to consult with an oncologist, regardless of the risks.

During the consultation, we ask a lot of questions, we are interested in everything: lifestyle, smoking experience, alcohol consumption, stress frequency, diet, appetite, body mass index, heredity, working conditions, how the patient sleeps at night, etc.If this is a woman, hormonal status, reproductive history are important: how old was the first child, how many births were there, whether the woman was breastfeeding, etc. It may seem to the patient that these questions are not related to his problem, but they are important for us, they allow us to compose an individual portrait of a person, assess the risks of developing certain cancers and prescribe exactly the set of examinations that he needs.

Personalized cancer check-up at the European Medical Center.

90,000 Aspergillosis Patient and Caregiver Support from NHS National Center for Aspergillosis Medicine, UK

Accurate diagnosis has never been easy for aspergillosis, but modern tools are evolving rapidly and are now improving the speed and accuracy of diagnosis. The patient present at the clinic will first be asked to report on the symptoms they have noticed. Depending on this history, a number of tests may be requested from the following list:

• Blood test
• X-ray or CT of the chest
• Skin test for measuring sensitivity to allergens Aspergillus
• Culture and analysis of sputum (mucus) sample
• Tissue culture, e.g. lungs (called BAL)
• Bronchoscopy – When a flexible tube is passed into the lungs during sedation.
• Sample or biopsy of tissue mass (if available) in the lung cavity

What do the tests show?

Blood Tests : Antibodies against Aspergillus proteins can be measured in the patient’s blood and this indicates whether the patient may have Aspergillus infection – this is done with a enzyme-linked immunosorbent assay (ELISA) such as ImmunoCAP ^® Specific blood test for IgE. . A positive result means that antibodies to the fungus have been detected. A positive test result is also a useful marker for subsequent comparisons to assess the effectiveness of treatment. Rarely, a false positive result can occur, so a number of different tests are used to diagnose aspergillosis. Sometimes markers of allergy to Aspergillus are positive in the blood. A test for a specific fungal molecule sometimes found in blood, called the galactomannan test, can also be done on a blood sample.

Other tests include blood count , plasma viscosity and C-reactive protein which may indicate inflammation – these markers usually improve with treatment, so a baseline is helpful. Liver and kidney function tests are important as liver function may be abnormal with antifungal drugs. In addition, some patients with aspergillosis may have low levels of a substance called mannose that binds lectin (MBL) and display abnormal genes for this protein.

A Chest X-ray allows visualization of the interior of the lungs and can identify an abnormality, such as any pulmonary cavities – formed as a result of another underlying disease or infection, or if fungal ball (aspergilloma) is present. In this case, a more advanced cross-sectional view of the lungs may be required. Computed Tomography (CT) may be needed. The procedure is based on X-rays to obtain a detailed image.You will need to lie still on a narrow table that slides into the center of the CT scanner, where the X-rays orbit around you. Scanning usually takes only a few minutes.

A skin test where a small needle is used to scratch the surface of the skin can be used to detect whether a patient has circulating IgE antibodies specific to Aspergillus . This is a more common test if you have asthma or ABPA. A positive result indicates that the patient is sensitized to Aspergillus . See the immune system.

A sample of sputum, other tissue fluids, or tissue biopsies may be sent to the culture laboratory to see if Aspergillus can be grown from the sample. Scientists use a special culture plate to grow mold, and if available, they often use a microscope to confirm the type of mold. Another way to detect Aspergillus with a sensitive molecular test method.

Bronchoscopy is a procedure in which a flexible tube is inserted into the lungs to monitor the lungs and airways – the patient is calmed during the procedure. Samples of lung tissue or fluid can be biopsied through a bronchoscope for examination in the laboratory using culture and molecular tests, if necessary. Learn more .

Biopsy These are small tissue samples taken from infected areas (eg lungs, sinuses) that are either sliced ​​thinly, stained and examined under a microscope, or placed in a culture medium that allows any fungus present to grow – then the fungus can be identified.

The results of the aforementioned tests are then reviewed together and if aspergillosis is confirmed, an appropriate treatment regimen will be initiated.

Conversations at Patient and Guardian Meetings at NAC

What is IgE? Resume for the layperson Start at 0 ′ 55 ′ 43 from

What is IgG? Resumes for the layperson Start at 0 ′ 29 ′ 14 seconds

Chest X-ray Investigation A Few Tips! Start at 0 51 ′ 22 ”sec

Symptoms:

Symptoms can vary greatly depending on the type of aspergillosis a patient may have.For example, one patient with aspergilloma may have few symptoms or just a cough, another may cough up large amounts of blood (hemoptysis) and require urgent medical attention. The following is a general list of some of the symptoms that can occur in patients with aspergillosis, but there is a big difference between patients.

• weight loss
• fatigue
• high temperature
• cough
• coughing up blood (hemoptysis)
• dyspnoea

A patient with some of these symptoms may not have aspergillosis – in fact, this is unlikely, unless the immune system is weakened (eg, after cancer treatment, organ transplants).If the person has not responded to multiple doses of antibiotics and is immunocompromised, then aspergillosis tests should be considered.

For more information on the types of aspergillosis, their symptoms and treatment, visit the following links:

Biochemical blood test for liver cirrhosis

A biochemical blood test for liver cirrhosis is prescribed by the doctor first. This disease is the replacement of normal fibrous tissue of the organ.The process is accompanied by a change in the size of the liver to a smaller or larger side, an increase in density and the appearance of tuberosity. These signs are detected during examination by a doctor and on an ultrasound examination. Laboratory diagnostics indicate functional changes. For accuracy, analyzes must be combined with other examination methods.

A blood biochemistry test in patients with compensated disease may give results within the normal range, but a slight increase in serum transaminase or gamma-glutamyl transpeptidase activity is also possible.The decompensated form is accompanied by symptoms:

• portal hypertension – increased pressure in the portal vein system due to blockage of intra-, extrahepatic vessels,
• hepatic failure is a syndrome involving a violation of several functions of the liver.

In case of liver cirrhosis, a biochemical blood test shows:

• increase in bilirubin, gamma globulins,
• reduction of albumin, protobin, cholesterol.

Test values ​​are significantly related to process activity.

So, if the patient undergoes complex tests, for example, biochemical and clinical, then the second with active cirrhosis of the liver shows:

• anemia,
• leukopenia,
• thrombocytopenia.

In the results of a biochemical test in 90 percent of patients, the activity of aminotransferases is increased 2-5 times. Bilirubin also exceeds the norm by at least two times.

In patients with alcoholic liver damage, the activity of gamma-glutamyl transferase is increased to a greater extent. If, if you suspect viral cirrhosis, you are tested for markers of hepatitis, then the tests will be positive. The indicator of the hepatitis D virus is found in the most pronounced viral cirrhosis.

A biochemical blood test for low-level cirrhosis shows abnormalities in 30-50 percent of cases. The concentration of total bilirubin is 1.5-2 times higher, the activity is 1.5-4 times higher.Decreased prothrombin index.

Cirrhosis is a multifactorial disease that, as it develops, leads to an immune-inflammatory process. Therefore, in addition to a biochemical test for cirrhosis of the liver, the doctor may prescribe an immunological study. It shows a decrease in the activity of T-lymphocytes, the formation of antibodies to the parenchyma, an increase in the concentration of immunoglobulins.

Comprehensive examinations are carried out at Litekh. Here you can do all the necessary analyzes and get expert opinion.

Laboratory tests – a method for diagnosing chronic heart failure

Chronic heart failure (CHF) is a disease in which the pumping function of the heart decreases. It cannot throw out the required amount of blood, which causes organs and tissues to suffer.
To identify the disease, a consultation with a cardiologist is required. But first, you can pass tests that will help a specialist in the diagnosis of heart failure.

1. General blood test. With progressive CHF, iron deficiency anemia may develop due to impaired absorption of iron in the intestine or insufficient intake of iron from food.

2. General analysis of urine. Perhaps the appearance of proteinuria, cylindruria, as markers of impaired renal function in chronic heart failure.

3. Biochemical blood test:
• For the diagnosis of possible liver dysfunctions – AST, ALT, total protein, bilirubin.AST and ALT are always given in pairs so that the doctor can see and separate the lesions of the heart and liver. Their increase, in most cases, indicates problems with the muscle cells of the heart, the occurrence of myocardial infarction.
• LDH (lactate dehydrogenase) and CPK (creatine phosphokinase) and especially its MB-fraction (MB-CPK) – increase in acute myocardial infarction.
• Myoglobin – increases as a result of the breakdown of muscle tissue in the heart or skeleton.
• Electrolytes (ions K, Na, Cl-, Ca2) – an increase in potassium entails a violation of the heart rhythm, the possible development of excitation and fibrillation of the ventricles; low potassium levels can cause a decrease in myocardial reflexes; an insufficient content of sodium ions and an increase in chlorides are fraught with the development of cardiovascular failure.
• Cholesterol – excess of it is associated with a risk of atherosclerosis and coronary heart disease. An increase in cholesterol levels (with significant impairment of liver function – hypocholesterolemia), triglycerides, low and very low density lipoproteins, a decrease in high density lipoproteins is possible with coronary heart disease.
• C-reactive protein – appears in the body during an inflammatory process or tissue necrosis that has already occurred, since it is contained in minimal values ​​in the blood serum of a healthy person.

4. Brain natriuretic peptide (BNP) – used as a marker in the diagnosis of heart failure. BNP levels are elevated in patients with left ventricular dysfunction. At the same time, the content of BNP in blood plasma significantly correlates with the functional classes of chronic heart failure. Determination of the BNP level in blood plasma helps to assess the severity of chronic heart failure, to predict the further development of the disease, and to assess the effect of the therapy.

5. Coagulogram – will give an idea of ​​the process of blood clotting, its viscosity, the possibility of blood clots or, conversely, bleeding. Can be given in addition to other tests.

You can take the necessary tests at the Federal State Budgetary Institution “NMITs TPM” of the Ministry of Health of Russia. Enjoy a comfortable treatment room and a fully equipped laboratory. Most analyzes are done within 1 business day.

For more details see reference

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