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 Digestive Disease & Surgery Institute

Common Tests for Liver Disease

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Overview
William D. Carey, MD

Laboratory assessment of the patient with suspected or clinically obvious liver disease is context
dependent. For example, the acutely ill jaundiced patient with a history of prolonged alcohol
ingestion requires a different laboratory assessment than the well patient in whom one or more
standard liver test results are discovered to be abnormal during routine testing. Additionally, the
sequence of liver tests depends heavily on the questions being asked. If it is to determine whether
this well person whose brother was recently diagnosed with hemochromatosis also has this
genetic disease, then a series of tests will be initiated to detect the possibility of iron overload. If
it is to determine whether this spouse has been infected with hepatitis B, then blood tests related
to hepatitis B will be required. Thus generic algorithms for the evaluation of liver disease need to
be considered skeptically.

This chapter is intended to discuss a useful way of thinking about liver tests. It emphasizes
limitations of and alternative explanations for isolated abnormalities of common liver test results.
It also provides information on the initial screening test to be chosen, their interpretation, and the
tests needed to confirm the diagnosis of common liver disorders based on current
recommendations. Information in this chapter should be combined with discussions of specific
liver diseases. A final caveat relates to terminology. Tests done in clinical laboratories do not
measure any functional capacity of the liver. Hence, the commonly used term liver function test
is inaccurate, and the term liver tests is used in this chapter. Guidelines on the interpretation and
evaluation of abnormal liver test results have been published. Useful algorithms are presented
that parallel the recommendations in this chapter.

Next: Isolated Abnormalities in Liver Test Results

GUIDE SECTION MENU

 Overview
 Isolated Abnormalities in Liver Test Results
 Evaluation Based on Enzyme Levels
 Determination of Specific Liver Disorders
 Conclusion
 Suggested Readings

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