Liver Disease And Related Laboratory Tests

On the right side of the body, located on the upper side of the abdomen, is the liver. Approximately the size of a football, the liver weighs about 2 to 3 pounds and works to do a variety of functions in the body, including the following:

  • Metabolize and detox harmful substances in the body
  • Convert nutrients that are derived from food into the vital blood components
  • Regulate the body’s ability to clot blood
  • Produce proteins and enzymes
  • Maintain the hormonal balance
  • Store specific vitamins
  • Contribute to the factors that aid in fighting the immune system
  • Remove toxic bacteria from the blood
  • Create bile that is vital for digestion

Bile is a green-yellow fluid that is comprised of bile acids or salts that are created via waste products like bilirubin that are created as red blood cells break down. This then flows through the small bile ducts that are located inside of the liver. Bile moves from the smaller sized ducts into the larger ones much in the same way that streams flow into a river and eventually converge into the main ducts and then exit the liver as the streams exit into a river. Part of the bile will then flow into the duodenum; the rest of the bile will flow into a storage facility and concentrate in the gallbladder. After eating, the gallbladder will then release some of the bile into the smaller sized intestine where it will then digest fats.

Any condition that causes liver inflammation or damage is liver disease. These conditions may also affect how the liver functions. Liver disease is categorized according to the cause and effect upon the liver. Causes can include things such as infection, exposure to drugs, exposure to toxic compounds, injury to the liver, autoimmune processes, genetic defects, and other conditions that may be due to deposits and build-up of metals in the liver, including iron and copper. The residual effects of such exposure are inflammation, injury, obstruction, scarring, abnormalities in blood clotting, and eventual liver failure.

Signs And Symptoms

In the beginning, liver disease may not have any signs or symptoms. Other symptoms may be quite non-specific. Weakness, lack of energy, and other symptoms may also present.

The most typical signs of acute liver disease include the following:

  • Yellowing of skin due to issues processing the bilirubin. These include jaundice, light stools, dark urine, and loss of appetite.
  • Nausea
  • Diarrhea
  • Vomiting

In addition to the conditions mentioned above, Chronic Conditions of liver disease may also include the following:

  • Itching or pruritus
  • Abdominal swelling (ascites)
  • Unexplained weight gain or loss
  • Abdominal pain

These symptoms typically present at a later stage of the disease.

General Laboratory Tests For Liver Disease

The main goal in screening for liver disease is to detect injury to the liver, evaluate the severity of the injury, and diagnose the cause. With time, these will then be monitored to watch for changes.

Early detection and screening are vital to the severity of symptoms, and many can be controlled if caught in time. The more that healthcare professionals can determine the severity, the more they can plan a care plan for managing the symptoms. The liver is fully capable of repairing injuries and in resolving inflammation if the bile ducts aren’t blocked. Blocked bile ducts can lead to cirrhosis and be permanent conditions that will lead to progressive liver damage. It’s important to monitor the status with time to help take any steps that will preserve the function of the liver.

General tests in the laboratory will measure the enzyme levels, protein, bilirubin, and other symptoms if there is an injury present.

Taking a comprehensive metabolic panel or CMP is a series of tests that are done in conjunction with general health screening. This includes several tests that will show the liver function.

A liver panel may also be ordered if there are any abnormalities in the CMP testing process results. These are done if there is any question on liver function or if there has been a liver injury.

Whenever there are abnormal test results, these tests may be administered for further evaluation of the liver. All these tests may also be administered individually to monitor a person who has been diagnosed with a liver condition. These tests may include the following:

Alanine aminotransferase or ALT. This is an enzyme that is mainly located in the liver and can also detect hepatitis.

Alkaline phosphatase or ALP. This enzyme is located in the bile ducts and liver and will increase if they are blocked.

Aspartate aminotransferase or AST. This enzyme is in the liver and other areas of the body, including the heart.

Gamma-glutamyl transferase or GGT. This enzyme is sensitive to changes in the liver status if the bile ducts are blocked.

Total bilirubin will measure the amount of bilirubin in the blood. The levels will be higher for many liver conditions.

Direct bilirubin will measure the type of bilirubin that is combined with other compounds and increases if liver disease is present.

Albumin is the main protein that is manufactured in the liver. It will tell how the liver is doing.

Total protein will measure the amount of the protein in the liver as well as the antibodies that are present to help ward off infections.

Lactate dehydrogenase or LDH. This enzyme is released with damaged tissue and may raise if there is acute liver disease.

Select Tests

Several tests may be ordered to diagnose liver dysfunction. Some are used to monitor the condition and others to diagnose.

Liver Biopsy: Small samples of the liver tissue are taken to evaluate the liver and the cells.

Ammonia: This could be elevated in the later stages of cirrhosis and liver failure.

Viral Hepatitis tests (A, B, And C): to detect viral infections in the liver.

Alpha-fetoprotein or AFP: will elevate with liver cancer.

Des-gamma-carboxy prothrombin or DCP: will also elevate with liver cancer.

Prothrombin time or PT: will show clotting function.

Iron tests: Hemochromatosis or iron metabolism disorders

Copper and Ceruloplasmin: Wilson’s Disease is a genetic copper metabolism disorder

Alpha 1 antitrypsin: will test for deficiency.

Antimitochondrial antibody or AMA: will diagnose biliary cholangitis or PBC.

There are tests for autoantibodies that will help to diagnose autoimmune hepatitis, including antinuclear antibodies or ANA. Antismooth muscle antibodies or ASMA and the F-actin antibodies for both liver and kidney microsomes or anti-LKM1. Acetaminophen levels and other overdose drug tests or if the person is doing drugs will also show.

CBC or complete blood count will show elevated white and red blood cells as well as platelets.