Acute liver failure laboratory findings

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Husnain Shaukat, M.D [2]

Overview

Acute liver failure can present with nonspecific symptoms and it occurs in healthy individuals without a previous history of liver disease. So, the initial labs in the acute liver failure are planned to evaluate both the etiology and the severity of the disease. All patients with clinical or laboratory evidence of moderate to severe acute hepatitis should have an immediate measurement of prothrombin time and careful evaluation of mental status. If the prothrombin time is prolonged (INR ≥1.5) and there is any evidence of altered sensorium, the diagnosis of acute liver failure should be strongly suspected and hospital admission is mandatory.

Laboratory Findings

  • Acute liver failure can present with nonspecific symptoms and it occurs in healthy individuals without a previous history of liver disease. So, the initial labs in the acute liver failure are planned to evaluate both the etiology and the severity of the disease.[1][2][3][4]
LAB values in Acute liver failure Comments
  • Increased
  • Low
  • Elevated
  • Liver enzymes are elevated in acute liver failure. The decrease in liver enzymes may indicate recovery or worsening of liver failure and an indication of hepatic mass loss.
  • Elevated
  • Bilirubin and PT/INR will continue to rise in liver failure but if a patient is improving, bilirubin and PT/INT will also improve.
  • Low
  • Albumin indicates the synthetic function of the liver.
  • Low
  • Elevated
  • Dectectable in viral hepatitis
  • Viral serology and PCR can detect the viral agent
  • Detectable in auto immune hepatitis.
  • Elevated
  • Elevated

References

  1. Polson J, Lee WM (2005). "AASLD position paper: the management of acute liver failure". Hepatology. 41 (5): 1179–97. doi:10.1002/hep.20703. PMID 15841455.
  2. Wasley A, Fiore A, Bell BP (2006). "Hepatitis A in the era of vaccination". Epidemiol Rev. 28: 101–11. doi:10.1093/epirev/mxj012. PMID 16775039.
  3. Khuroo MS, Kamili S (2003). "Aetiology and prognostic factors in acute liver failure in India". J. Viral Hepat. 10 (3): 224–31. PMID 12753342.
  4. Torres HA, Davila M (2012). "Reactivation of hepatitis B virus and hepatitis C virus in patients with cancer". Nat Rev Clin Oncol. 9 (3): 156–66. doi:10.1038/nrclinonc.2012.1. PMID 22271089.



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