Home

 What is Hepatitis

 How is it Transmitted

 Long Term Prognosis

 Complications of HCV

 Liver Biopsy

 Treatment Info (Interferon, Herbal, etc)

 Lab Tests (PCR, Genotype,etc.)

 Nutrition & Alternative Info

 Patient Information (Support Groups, Doctor Listing, etc)

 Related Webpages

 Transplant Info

 Site Search

 HCV Webrings

 My guestbookbook

 Site Awards

 FAQ & Disclaimers


CLINICAL APPROACH TO THE PATIENT WITH ABNORMAL LIVER TEST RESULTS

Abnormal results of standard biochemical liver tests occur frequently; however, the prevalence of clinically significant liver disease is only about 1% in all patients screened. Thus, development of a rational and cost-effective approach to these patients is important. Liver diseases are generally classified as hepatocellular, cholestatic, and infiltrative, Cholestatic liver disease is further categorized as intrahepatic and extrahepatic. Hepatocellular disease is characterized by transaminase increases greater than 5 times the upper limit of normal, with alkaline phosphatase levels usually increased less than 2 to 3 times the upper limit of normal. Cholestatic disease is characterized by an increase in the alkaline phosphatase level that is 3 to 5 times greater than the upper limit of normal, with only a mild increase of transaminases. The exception to this is cholestasis with cholangitis when the transaminases can be more substantially increased, In infiltrative diseases of the liver such as lymphoma or granulomatous hepatitis, the alkaline phosphatase level is increased disproportionately to that of the bilirubin. Specific etiologic diagnoses cannot usually be based on routine biochemical liver test results, and thus more specialized serum tests are necessary. A liver biopsy is often needed for a precise diagnosis in patients with long-term increases in liver test results. Ultrasonography is the best initial imaging technique for the liver, and if biliary dilatation is noted, endoscopic retrograde cholangiopancreatography is recommended.

Author: KAMATH PS, MAYO CLIN & MAYO FDN, DIV GASTROENTEROL, 200 1ST ST SW, ROCHESTER, MN 55905
Source: MAYO CLINIC PROCEEDINGS 1996 NOV;71(11):1089-1095


Home | What is HCV | Transmission | Future | Complications | Biopsy | Treatment | Lab | Nutrition | Patient | Links | Transplant | Webrings | guestbookbook | Awards | FAQ |