Acute liver failure laboratory findings: Difference between revisions

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*Toxicology screen ([[Acetaminophen|acetaminophen level]])
*Toxicology screen ([[Acetaminophen|acetaminophen level]]) and blood alcohol level
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Revision as of 18:44, 16 November 2017

Acute liver failure Microchapters

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


Overview

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 by ≈ 4-6 seconds or more (INR ≥1.5) and there is any evidence of altered sensorium, the diagnosis of ALF should be strongly suspected and hospital admission is mandatory.

Laboratory Findings

  • The initial labs in the acute liver failure are planned to evaluate both the etiology and the severity of the disease.[1].
LAB values in Acute liver failure Comments
  • Increased
  • Prolonged prothrombin time, resulting in an INR ≥1.5; it shows coagulopathy which is a part of acute liver failure criteria.
  • Low
  • Anemia may be present
  • 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 loss of hepatic mass.
  • Elevated
  • Bilirubin and PT/INR will will continue to rise in liver failure bua patienttient is improving, bilirubin and PT/INT will also improve.
  • Low
  • Albumin indicates the synthetic function of the liver.
  • Low
  • Decrease hepatic glycogenolysis and gluconeogenesis
  • Elevated
  • Decrease clearance in hepatorenal syndrome
  • Detectable in acetaminophen poisioning
  • Dectectable in viral hepatitis
  • Viral serology and PCR can detect the viral agent
  • Detectable in auto immune hepatitis.
  • Antibody screen can detect antibodies associated with autoimmune hepatitis such as anti-smooth muscle antibody or ANA.
  • Elevated in wilson's disease
  • Elevated
  • Blood lactate is elevated due to decrease hepatic clearance and ischemia to hepatic tissue
  • Elevated
  • Decrease ammonia clearance

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.

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