American Liver Foundation - Liver Function Tests. Explore this section to learn more about Liver Function Tests, including a description and diagnosis. Why is the liver important? The liver is the second largest organ in your body and is located under your rib cage on the right side. It weighs about three pounds and is shaped like a football that is flat on one side. LiverSupport.com - The most up-to-date, comprehensive information on liver diseases, news, liver healthy recipes, & high-quality liver supplements and more. Variability of capillary blood glucose monitoring measured on home glucose monitoring devices. Contact Us. American Liver Foundation 39 Broadway, Suite 2700 New York, New York 10006. 212-668-1000 Tel 212-483-8179 Fax. · The common pathway in life-threatening acute anemia is a sudden reduction in the oxygen-carrying capacity of the blood. Depending on the etiology, this may. Hello My husband 56 years old has a higher level of sgpt and sgot which is 187 and 92 respectively. He had been taking medicine to lower down this enzymes and also he. How to interpret your blood test results. for accurate interpretations please consult your health care professional. Pneumonia Description. An in-depth report on the causes, diagnosis, treatment, and prevention of pneumonia. Highlights. Overview. While the incidence of pneumonia is. Human liver anatomy, function, location, parts & diseases – an up-to-date study. The hottest and largest internal organ and the largest gland, liver performs 500. Clinical Guidelines. Authored by a talented group of GI experts, the College is devoted to the development of new ACG guidelines on gastrointestinal and liver diseases. The liver performs many jobs in your body. It processes what you eat and drink into energy and nutrients your body can use. The liver also removes harmful substances from your blood. What are “liver function tests”? Liver function tests help your doctor check your liver’s health and detect liver damage. These blood tests measure the levels of certain proteins and enzymes in your blood. Proteins are large molecules that are needed for your overall health. Enzymes are cellular proteins that help important chemical reactions to occur in your body. Why are liver function tests done? Liver function tests may be done for many reasons. Some doctors perform these tests as part of a regular checkup. Other doctors may use liver function tests to screen patients who are at risk for liver disease. Doctors also use them to monitor a person’s liver disease and to check if treatment is working. What are the commonly used liver function tests? Liver Enzyme Tests. Alanine Transaminase (ALT) is an enzyme mainly found in your liver. The ALT test measures the level of ALT in your blood. Consistently high levels of ALT in your blood can be a sign of liver damage. Aspartate Transaminase (AST) is an enzyme found in large amounts in your liver and other parts of your body. The AST test measures the level of AST in your blood. High levels of AST can be a sign of liver damage. Alkaline Phosphatase (ALP) is an enzyme found in large amounts in your liver, bile ducts, and other parts of your body. The ALP test measures the level of ALP in your blood. High levels of ALP can be a sign of liver or bile duct damage. Gamma- glutamyl transpeptidase (GGT) is an enzyme found in large amounts in your liver, bile ducts, and pancreas. The GGT test measures the level of GGT in your blood. High levels of GGT can be a sign of liver or bile duct damage. Liver Protein Tests. Total Protein measures the amount of protein in your blood. The two main proteins found in the blood are globulins and albumin. Globulin is a protein made in your liver and helps the immune system fight infections. Low globulin levels can be a sign of liver damage or other conditions. Albumin is another protein made in your liver. An albumin test measures how well your liver is making the proteins that your body needs. Low albumin levels can be a sign of liver damage. Prothrombin is a protein made in your liver and helps with clotting blood. A prothrombin time test measures how much time it takes for your blood to clot. A high prothrombin time can be a sign of liver damage. Bilirubin Tests. Bilirubin is a yellow fluid made in your body when red blood cells break down. A bilirubin test measures the level of bilirubin in your blood. If your liver is damaged, bilirubin can leak out of your liver into your blood and can cause jaundice (yellowing of skin and eyes). It also can come out in the urine making it look very dark. How do you prepare for liver function tests? Your doctor may ask you to not eat or drink and avoid medications before your blood tests. Certain foods and medications may affect your liver function test results. Tell your doctor about all the prescription, over the counter and herbal supplements you are taking. What are normal ranges for liver function tests? Normal ranges for liver function tests can vary by age, gender and other factors. Laboratory test results usually provide normal ranges for each liver function test with your results. Talk to your doctor about your results. Page updated: January 2. Liver Disease: Symptoms, Signs & Treatment. What are the causes of liver disease (hepatitis and others)? Infectious hepatitis. The term "hepatitis" means inflammation, and liver cells can become inflamed because of infection. Hepatitis A is a viral infection that is spread primarily through the fecal- oral route when small amounts of infected fecal matter are inadvertently ingested. Hepatitis A causes an acute inflammation of the liver which generally resolves spontaneously. The hepatitis A vaccine can prevent this infection. Thorough hand washing, especially when preparing food is the best way to prevent the spread of hepatitis A. This is especially important for workers who work in the food and restaurant industries. Hepatitis B is spread by exposure to body fluids (needles from drug abusers, contaminated blood, and sexual contact) and can cause an acute infection, but can also progress to cause chronic inflammation (chronic hepatitis) that can lead to cirrhosis and liver cancer. The hepatitis B vaccine can prevent this infection. Hepatitis C causes chronic hepatitis. An infected individual may not recall any acute illness. Hepatitis C is spread by exposure to body fluids (needles from drug abusers, contaminated blood, and some forms of sexual contact). Chronic hepatitis C may lead to cirrhosis and liver cancer. At present, there is no vaccine against this virus. There is a recommendation to test all people born between 1. Hepatitis C antibody to identify people who do not know that they have contracted the disease. Newer medications are now available to treat and potentially cure Hepatitis C. Hepatitis D is a virus that requires concomitant infection with hepatitis B to survive, and is spread via body fluid exposure (needles from drug abusers, contaminated blood, and sexual contact). Hepatitis E is a virus that is spread via exposure to contaminated food and water. Other viruses. Other viruses can also cause liver inflammation or hepatitis as part of the cluster of symptoms. Viral infections with infectious mononucleosis (Epstein Barr virus), adenovirus, and cytomegalovirus can inflame the liver. Non- viral infections such as toxoplasmosis and Rocky Mountain spotted fever are less common causes. Non- alcoholic fatty liver disease. NASH or non- alcoholic steatohepatitis (also referred to as "fatty liver") describes the accumulation of fat within the liver that can cause inflammation of the liver and a gradual decrease in liver function. Hemochromatosis. Hemachromatosis (iron overload) is a metabolic disorder that leads to abnormally elevated iron stores in the body. The excess iron may accumulate in the tissues of the liver, pancreas, and heart and can lead to inflammation, cirrhosis, liver cancer, and liver failure. Hemachromatosis is an inherited disease. Wilson's disease. Wilson's disease is another inherited disease that affects the body's ability to metabolize copper. Wilson's disease may lead to cirrhosis and liver failure. Gilbert's disease. In Gilbert's disease, there is an abnormality in bilirubin metabolism in the liver. It is a common disease that affects up to 7% of the North American population. There are no symptoms and it is usually diagnosed incidentally when an elevated bilirubin level is found on routine blood tests. Gilbert's disease is a benign condition and requires no treatment. What Is Drug Induced Liver Disease? Symptoms, Signs & Types. What is the treatment for drug- induced liver disease? The most important treatment for drug- induced liver disease is stopping the drug that is causing the liver disease. In most patients, signs and symptoms of liver disease will resolve and blood tests will become normal and there will be no long- term liver damage. There are exceptions, however. For example, Tylenol overdoses are treated with oral N- acetylcysteine to prevent severe liver necrosis and failure. Liver transplantation may be necessary for some patients with acute liver failure. Some drugs also can cause irreversible liver damage and cirrhosis. What are some important examples of drug- induced liver disease? Acetaminophen (Tylenol)An overdose of acetaminophen can damage the liver. The probability of damage as well as the severity of the damage depends on the dose of acetaminophen ingested; the higher the dose, the more likely it is that there will be damage and the more likely it is that the damage will be severe. The reaction to acetaminophen is dose- dependent and predictable; it is not idiosyncratic - peculiar to the individual.) The liver injury from an overdose of acetaminophen is a serious matter since the damage can be severe and result in liver failure and death. In fact, acetaminophen overdose is the leading cause of acute (rapid onset) liver failure in the U. S. and the United Kingdom. For the average healthy adult, the recommended maximum dose of acetaminophen during a 2. Each extra- strength tablet contains 5. Among children, the dose of acetaminophen is determined on the basis of each child's weight and age, explicitly stated in the package insert. If these guidelines for adults and children are followed, acetaminophen is safe and carries essentially no risk of liver injury. A person who drinks more than two alcoholic beverages per day, however, should not take more than 2 grams (2. A single dose of 7 to 1. Among children, a single dose of 1. Nevertheless, 3 to 4 grams ((3. It seems that certain individuals, for example, those who regularly drink alcohol, are more prone than others to developing acetaminophen- induced liver damage. Other factors that increase a person's risk for damage from acetaminophen include the fasting state, malnutrition, and concomitant administration of some other drugs such as phenytoin (Dilantin), phenobarbital, carbamazepine [(Tegretol) (anti- seizure medications)] or isoniazid [(Nydrazid, Laniazid) (anti- TB drug)]. Please read the Tylenol Liver Damage article for a detailed discussion of the symptoms, mechanisms of acetaminophen toxicity, treatment (early use of N- acetylcysteine), and prevention. Statins. Statins are the most widely used medications to lower "bad" (LDL) cholesterol in order to prevent heart attacks and strokes. Most doctors believe that statins are safe for long- term use, and important liver injury is rare. Nevertheless, statins can injure the liver. The most common liver- related problem caused by statins is mild elevations in blood levels of liver enzymes (ALT and AST) without symptoms. These abnormalities usually improve or completely resolve upon stopping the statin or reducing the dose. There is no permanent liver damage. Patients with obesity have an increased chance of developing diabetes, non- alcoholic fatty liver disease (NFALD), and elevated blood cholesterol levels. Patients with fatty liver often have no symptoms, and the abnormal tests are discovered when routine blood testing is done. Recent studies have found that statins can be used safely to treat high blood cholesterol in patients who already have fatty liver and mildly abnormal liver blood tests when the statin is started. In these patients, doctors may choose to use statins at lower doses and monitor liver enzyme levels regularly during treatment. Nevertheless, idiosyncratic liver toxicity capable of causing severe liver damage (including liver failure leading to liver transplantation) has been reported with statins. The frequency of severe liver disease caused by satins is likely in the range of 1- 2 per million users. As a precaution, the FDA labeling information advises that liver enzyme blood tests should be performed before and 1. Nicotinic acid (Niacin)Niacin, like the statins, has been used to treat elevated blood cholesterol levels as well as elevated triglyceride levels. Also like the statins, niacin can damage the liver. It can cause mild transient elevations in blood levels of AST and ALT, jaundice, and, in rare instances, liver failure. Liver toxicity with niacin is dose- dependent; toxic doses usually exceed 2 grams per day. Patients with pre- existing liver diseases and those who drink alcohol regularly are at higher risk for developing niacin toxicity. The sustained- release preparations of niacin also are more likely to cause liver toxicity than the immediate- release preparations. Amiodarone (Cordarone)Amiodarone (Cordarone) is an important medication that is used to treat irregular heart rhythms such as atrial fibrillation and ventricular tachycardia. Amiodarone can cause liver damage ranging from mild and reversible liver blood enzyme abnormalities, to acute liver failure and irreversible cirrhosis. Mild liver blood test abnormalities are common and typically resolve weeks to months after stopping the drug. Serious liver damage occurs in less than 1% of patients. Amiodarone differs from most other drugs because a substantial amount of amiodarone is stored in the liver. The stored drug is capable of causing fatty liver, hepatitis, and, more importantly, it can continue to damage the liver long after the drug is stopped. Serious liver damage can lead to acute liver failure, cirrhosis, and the need for liver transplantation. Methotrexate (Rheumatrex, Trexall)Methotrexate (Rheumatrex, Trexall) has been used for the long- term treatment of patients with severe psoriasis, rheumatoid arthritis, psoriatic arthritis, and some patients with Crohn's disease. Methotrexate has been found to be a cause of liver cirrhosis in a dose- dependent fashion. Patients with pre- existing liver diseases, obese patients, and those who drink alcohol regularly are particularly at risk of developing methotrexate- induced cirrhosis. In recent years, doctors have substantially decreased methotrexate liver damage by using low doses of methotrexate (5- 1. Some doctors also perform liver biopsies on patients without liver symptoms after two years (or after a cumulative dose of 4 grams of methotrexate) to look for early liver cirrhosis. Antibiotics. Isoniazid (Nydrazid, Laniazid). Isoniazid has been used for decades to treat latent tuberculosis (patients with positive skin tests for tuberculosis, without signs or symptoms of active tuberculosis). Most patients with isoniazid- induced liver disease only develop mild and reversible elevations in blood levels of AST and ALT without symptoms, but approximately 0. The risk of developing isoniazid hepatitis occurs more commonly in older patients than younger patients. The risk of serious liver disease is 0. At least 1. 0% of the patients who develop hepatitis go on to develop liver failure and require liver transplantation. The risk of isoniazid liver toxicity is increased with chronic regular alcohol intake, and with concomitant use of other medications such as Tylenol and rifampin (Rifadin, Rimactane). Early symptoms of isoniazid hepatitis are fatigue, poor appetite, nausea, and vomiting. Jaundice may then follow. Most patients with isoniazid hepatitis recover fully and promptly after stopping the drug. Severe liver disease and liver failure mostly occur in patients who continue to take isoniazid after the onset of hepatitis. Therefore, the most important treatment for isoniazid liver toxicity is early recognition of hepatitis and discontinuation of the isoniazid before serious liver injury has occurred. Nitrofurantoin. Nitrofurantoin is an anti- bacterial drug that is used to treat urinary tract infections caused by many gram- negative and some gram- positive bacteria. Nitrofurantoin was approved by the FDA in 1. There are three forms of nitrofurantoin available: a microcrystalline form (Furadantin), a macrocrystalline form (Macrodantin), and a sustained release, macrocrystalline form used twice daily (Macrobid). Nitrofurantoin can cause acute and chronic liver disease. Most commonly, nitrofurantoin causes mild and reversible elevations in blood levels of liver enzymes without symptoms. In rare instances, nitrofurantoin can cause hepatitis. Symptoms of nitrofurantoin hepatitis include: fatigue,fever,muscle and joint aches,poor appetite,nausea,weight loss,vomiting,jaundice, andsometimes itching. Some patients with hepatitis also have a rash, enlarged lymph glands, and nitrofurantoin- induced pneumonia (with symptoms of cough and shortness of breath). Blood tests usually show elevated liver enzymes and bilirubin. Recovery from hepatitis and other skin, joint, and lung symptoms is usually rapid once the drug is stopped. Serious liver disease such as acute liver failure and chronic hepatitis with cirrhosis mostly occur in patients who continue the drug despite developing hepatitis. Augmentin. Augmentin is a combination of amoxicillin and clavulanic acid. Amoxicillin is an antibiotic that is related to penicillin and ampicillin. It is effective against many bacteria such as H. N. gonorrhea, E. coli, Pneumococci, Streptococci, and certain strains of Staphylococci, Addition of clavulanic acid to amoxicillin in Augmentin enhances the effectiveness of amoxicillin against many other bacteria that are ordinarily resistant to amoxicillin. Augmentin has been reported to cause cholestasis with or without hepatitis. Augmentin- induced cholestasis is uncommon, but has been implicated in hundreds of cases of clinically apparent acute liver injury.
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