Liver Function Tests
Liver Function Tests
Liver Function Tests
Functions of liver Excretory Function:Bilepigments, bile salts and other organic anions like BSP (Bromosulphthalein), Indocyanine green (ICG), Urobilinogen Metabolic Functions
Test based on this function Van den Bergh Test Fouchets test Ehrlich test BSP Excretion Test 1. 2. 3. Galactose tolerance test Rate of Urea synthesis Plasma amino acid levels
Synthetic function
Serum total protein level Serum albumin level Prothrombin time . Hippuric acid test 1.Transaminases 2.Alkaline Phosphatase 3.gamma glutamyl transpeptidase 4.51 Nucleotidase 5.Leucineamino peptidase
Type of bilirubin
Normal ranges
Conjugated bilirubin
0 to 0.2 mg/dl
Obstructive jaundice or regurgitation jaundice or Post hepatic Jaundice Prehepatic or hemolytic Jaundice
Unconjugated bilirubin
0.2 to 1 mg/dl
0.2 to 1 mg/dl
10 ml of urine + few Bilirubin and biliverdin crystals of magnesium gets oxidized to blue or sulphate.heat with green compounds barium chloride solution A white ppt. of barium sulphate is formed to which bilirubin adheres if present.This is collected on to a filter paper and Fouchets reagent is added (Ferric Chloride In Trichloro acetic acid)
Pink colour 1.Increased UBG which persists even after 10 times dilution 2. Decreased UBG
2. Obstructive
4. Bile salts in urine : This is seen in Obstructive Jaundice. This is detected By Hays Test.
Test Observation Inference
Sprinkle some Sulphur 1. Sulphur powder powder to 5 ml of floats at the top urine in a test 2.sulphur powder tube sinks to the bottom
5. Bromosulphthalein test:
A single dose of BSP (50 g/l) is given and the serum concentration is measured at 45 minutes and at 2 hours. In normal people after 45 minutes less than 5% is retained. Any Increase in retention time indicates Hepatocellular impairment.
Thymol turbidity test: The turbidity produced in the serum sample on adding a thymol solution in barbitone buffer is estimated photometrically. The turbidity is increased in viral hepatitis, primary biliary cirrhosis, Multiple myeloma due to excess production of gamma globulins.
Zinc Sulphate turbidity test The turbidity produced in the serum sample on adding Zinc sulphate solution in barbitone buffer is estimated photometrically. The turbidity is increased in viral hepatitis, due to excess production of gamma globul
Tests based on synthetic function All plasma proteins except immunoglobulins are synthesized in the liver. therefore the measurement of serum proteins forms a reliable index of liver function. Serum albumin levels Albumin level is decreased in almost all liver diseases. A reversal of albumin globulin ratio is seen in Cirrhosis. This may be due to hypoalbuminemia and associated hypergammaglobulinemia. b) Serum total protein levels. In chronic liver diseases serum total protein levels are decreased.
c) Prothrombin time:
Prothrombin is synthesized in the liver and hence forms an useful indicator of liver function. Prolonged Prothrombin time due to vitamin K deficiency can be ruled out by estimating Prothrombin time before and after parenteral administration of vitamin K. In acute or chronic hepatocellular injury Prolonged Prothrombin time is seen even after administration of vitamin K indicating imminent hepatic failure and a poor prognosis.
ALT
0 to 40 IU/L
ALP
0 to 145 U/L
GGT
10 to 30 IU/L
5.5Nucleotidase
2 to 10 IU/L