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Dr. David Bernstein Discusses
Liver Function Tests
January 18, 2000
Please discuss the normal (standards) of all liver values (alc phos, thrombocite count , sglot , ama , bilrubin ) and all other blood values that are taken with PBC/Liver Cirrhosis blood tests.
Why are these tests needed?
What do the doctors look for in these test?
Do most doctors relay more on the patients symptoms or the blood labs?
Dr. Bernstain wrote:
Liver tests are used to evaluate patients with liver disease. The most common abnormality in PBC is the alklaine phosphatase. This is an enzyme found on the outside of liver cells. Its degree of elevation does not correlate with the extent of liver damage seen on liver biopsy.
Not uncommonly, the ALT and AST are mildly elevated in PBC. In early disease, these may be the first tests that are abnormal. Most of the time these tests are normal in PBC.
The platelet count is generally normal in PBC until more advanced liver disease occurs. Low platelets are a sign of portal hypertension and possible cirrhosis. This is a very valuable test used by doctors to determine extent of disease.
Bilirubin is usually normal throughout the course of PBC. An elevated bilirubin is of concern and should prompt an immediate evaluation. In general, bilirubin levels do not fluctuate in PBC unless treatment is initiated.
When a doctor notes an elevated bilirubin in PBC, it should warrant concern and furhter consulation with the patient.
The AMA is used to diagnose PBC and is positive in 95-98% of people with PBC. Its titer does not correlate with extent of disease. This test is usually only obtained once in the course of the disease to make the diagnosis.
Despite all these blood tests, doctors rely more on the patients symptoms than blood tests to assess a patients overall condition.
However, a rising prothrombin time, decreasing albumin or rising bilirubin are of concern and will prompt swift action.
