Abstract:Diseases of the liver encompass a wide variety of clinical conditions that range from mild abnormalities on liver testing to end-stage liver disease with intrahepatic and extrahepatic manifestations a...Diseases of the liver encompass a wide variety of clinical conditions that range from mild abnormalities on liver testing to end-stage liver disease with intrahepatic and extrahepatic manifestations and complications. These also range from acute, self-limited presentations to fulminant disease with rapid liver failure to chronic, low-level disease and also to chronic liver disease that progresses slowly over time. While the history and physical signs of this broad range of clinical disorders are quite similar, often with nonspecific findings with broad-range differentials, laboratory evaluation is critical to sorting through these disease processes. It is critical for family physicians to have an understanding of liver pathology and the laboratory assessment of the hepatic system. “Liver function tests” is often a misnomer used to describe a variety of tests that assess hepatic synthetic function (e.g., serum albumin, prothrombin time), excretory function (e.g., serum bilirubin, direct bilirubin), necroinflammatory activity (e.g., alanine aminotransferase or ALT/SGPT, aspartate aminotransferase or AST/SGOT, and g-glutamyltransferase or GGT), and cholestasis (alkaline phosphatase). While these tests can aid in the correct identification of liver disease, a single elevation must be confirmed with a second test. Furthermore, normal or minimally abnormal tests do not preclude the presence of significant liver disease or possibly advanced disease or cirrhosis. While these tests will demonstrate liver disease, they are nonspecific and require specific testing based on risk factors, history, and laboratory evaluation directed at specific etiologies. The major causes of liver disease include infectious hepatitis, excessive alcohol usage, and toxic hepatopathy from drugs or other substances; however, less common metabolic abnormalities can also result in chronic liver disease and cirrhosis (see Table 1). This chapter will review the more common causes and their associated complications.Read More
Publication Year: 2015
Publication Date: 2015-01-01
Language: en
Type: article
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