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Liver Tests

Liver function tests (LFT)

These consist of many different blood tests that check for the levels of enzymes, bilirubin, and liver proteins.

There are four liver enzymes included in routine lab tests that can indicate the presence of disease.

  • AST or SGOT (aspartate aminotransferase – serum glutamic-oxalocetic transaminase)
  • ALT or SGPT (alanine aminotransferase – serum glutamic-pyruvic transaminase)
  • AP (alkaline phosphatase)
  • GGTP (gamma-glutamyl transpeptidase)

Elevations of the transaminase (AST and ALT) levels can be caused by the followng:

  • viral hepatitis
  • a fatty liver
  • alcoholism
  • a drug or medication-induced disease
  • autoimmune hepatitis
  • herbal toxicity
  • genetic liver disease
  • liver tumors
  • heart failure

Elevations of the cholestatic (AP and GGTP) enzymes can indicate:

  • primary biliary cirrhosis
  • primary sclerosing cholangitis (inflammation and narrowing of the bile ducts)
  • a fatty liver or nonalcoholic steatohepatitis (NASH)
  • alcohol-induced disease
  • liver tumors
  • drug-induced liver disease
  • gallstones

Elevated bilirubin levels can indicate the following:

  • primary biliary cirrhosis
  • primary sclerosing cholangitis
  • alcoholic hepatitis
  • hemolysis (RBC destruction)
  • drug induced liver disease
  • choledocholithiasis (gallstones in the bile duct)
  • liver failure
  • tumors of the liver/bile ducts or gallbladder
  • viral hepatitis
  • benign disorders of bilirubin metabolism as in Gilbert’s disease

Liver proteins made by the liver include:

  • albumin
  • prothrombin (factor II)
  • immunoglobulins

Abnormal levels can indicate a liver problem.

A liver biopsy is the removal of a tiny piece of liver tissue, using a special needle. The fragment taken resembles a one-inch piece of string or a tiny worm. This sample is sent to a lab for examination.

Blood tests used to diagnose specific liver diseases

Hepatitis A

  • Hepatitis A Antibody IgM
  • IgG

Hepatitis B

  • Hepatitis B core Antibody (HbcAb)
  • Hepatitis B surface Antigen (HbsAg)
  • Hepatitis B surface Antibody (HbsAb)
  • Hepatitis B e Antibody (HbeAb)
  • Hepatitis B e Antigen (HbeAg)
  • Hepatitis B viral DNA (HBV DNA)

Hepatitis C

  • Hepatitis C Virus Antibody (HCVAb)
  • Hepatitis C Virus Ribonucleic Acid (HCV RNA)
  • Elevated Immunoglobulin G (IgG)

Autoimmune Hepatitis

  • Antinuclear Antibody (ANA)
  • Smooth Muscle Antibody (SMA)
  • Antiliver/Kidney Microsomal Antibody (LKMAb)
  • Elevated Immunoglobulin G (IgG)

Primary Biliary Cirrhosis

  • Antimitochondrial Antibody (AMA)
  • Elevated Immunoglobulin M (IgM) (PBC)

Alcoholic Liver Disease

  • Blood Alcohol Level
  • Elevated Immunoglobulin A (IgA)
  • Mean Corpuscular Volume (MCV) >95 fl
  • Vitamin B12 and Folate Deficiency
  • Desialylated Transferrin Level

Hemochromatosis (accumulation of iron in tissues)

  • Iron (Fe)
  • Ferritin
  • Per Cent Transferrin Saturation
  • Total Iron Binding Capacity (TIBC)
  • Gene Testing for:
    • Histocompatibility Leukocyte Antigens (HLA-H)
    • DNA Probe Analysis by PCR

Liver Cancer (Hepatoma)

  • Alpha-Fetoprotein (AFT) >400ng/dl

This page was updated in December 2005.