Scribd
Upload
63 views

Clinical Presentation

The document discusses liver function tests and their uses. It describes the excretory, metabolic, protective and other functions of the liver. Common clinical manifestations of liver disease include jaundice and chronic hepatitis. Liver function tests assess liver damage, disease progression, surgical risk, and exposure to toxic substances. Routinely performed tests analyze abnormalities in bile, certain enzymes, and plasma proteins. The document also provides details on serum transaminase tests for SGPT/ALT and SGOT/AST which measure the activity of these liver enzymes.

Uploaded by

Rency Elizabeth
Copyright
© Attribution Non-Commercial (BY-NC)
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PPT, PDF, TXT or read online on Scribd
63 views

Clinical Presentation

The document discusses liver function tests and their uses. It describes the excretory, metabolic, protective and other functions of the liver. Common clinical manifestations of liver disease include jaundice and chronic hepatitis. Liver function tests assess liver damage, disease progression, surgical risk, and exposure to toxic substances. Routinely performed tests analyze abnormalities in bile, certain enzymes, and plasma proteins. The document also provides details on serum transaminase tests for SGPT/ALT and SGOT/AST which measure the activity of these liver enzymes.

Uploaded by

Rency Elizabeth
Copyright
© Attribution Non-Commercial (BY-NC)
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PPT, PDF, TXT or read online on Scribd
You are on page 1/ 14

LIVER FUNCTION TESTS

LIVER FUNCTIONS
Excretory functions: Bile formation and excretion of bile into the intestine.
Metabolic functions: The liver is the center of

metabolic activity for carbohydrate, protein and lipids. Protective functions and Detoxication Hematologic functions: Hematopoiesis and coagulation Circulatory functions

CLINICAL MANIFESTATIONS OF LIVER DISEASE


Jaundice Chronic hepatitis : It is defined as hepatic inflammation persisting without improvement for six months. The various causes include chronic infection with hepatitis B (or C), alcohol and drugs and autoimmune liver damage. Serum bilirubin and transaminase (SGPT, SGOT) are moderately elevated in all types. Altered drug metabolism Endocrine abnormalities: Liver plays a key role in the uptake and metabolism of hormones

Nutritional and metabolic abnormalities Since intake and disposition of nutrients in patients

with chronic liver disease are altered, these patients are subject to nutritional imbalance. These are as follows Decreased glucose tolerance (due to insulin resistance) Hypoalbuminemia (due to decreased albumin synthesis) Impaired absorption of fat-soluble vitamins (A, D, E and K)

THE USES OF LIVER FUNCTION TESTS


To assess the severity of liver damage in known liver disease. To follow the trend of the disease. To gauge post-operative risk. To screen the persons exposed to potential hepatotoxic materials in industry. To screen the persons exposed to hepatotoxic drugs to treat some other disease.

THE ROUTINELY PERFORMED LIVER FUNCTION TESTS (LFTs)


These are based on the following disorders -

1.Abnormalities of bile pigments and bile salts


excretion Serum total, direct and indirect bilirubin. Urine bile salts, bile pigments

2.Changes in certain enzymes SGPT (ALT) SGOT (AST) Alkaline phosphatase (ALP)
3.Changes in plasma proteins Determination of Total proteins, albumin globulin and A/G ratio.

SERUM TRANSAMINASES-SGPT (REITMAN & FRANKEL METHOD)


PRINCIPLE:
GPT (ALT) - Glutamate pyruvate transaminases or alanine

transaminase catalyses the transfer of an amino group from l- alanine to - ketoglutarate resulting in the formation of pyruvate and L-glutamate respectively. Pyruvate so formed, couples with 2, 4, DNPH in an alkaline medium to form a brown coloured hydrazone complex. The intensity of the brown colour is proportional to SGPT (ALT) activity and is measured photometrically. pyruvate. L-glutamate +

L-alanine + - ketoglutarate

PROCEDURE:
Blank GPT Substrate Std. Sodium Pyruvate (ml) D/W (ml) Serum Sample DNPH reagent (ml) 0.50 -0.10 -0.50 1 0.45 0.05 0.10 -0.50 2 0.40 0.10 0.10 -0.50 3 0.35 0.15 0.10 -0.50 4 0.30 0.20 0.10 -0.50 Test 0.50 --0.10 0.50

Mix thoroughly and keep at RT for 20 min. 0.4N NaOH (ml) Karmen Units 5.0 0.0 5.0 28.0 5.0 57.0 5.0 5.0 97.0 150.0 5.0

Mix and keep at room temperature for 10 min. Absorbance at 530 nm Draw a curve of Karmen units on X axis versus absorbance on Y axis

and determine concentration of GPT.

The graph is not linear but a curve as the O.D increases with increase in enzyme activity at a decreasing rate. Normal value: 5 35 U/L
1 Karmen Units/ml = 0.48 U/Litre Clinical

significance: SGPT- Carbon tetrachloride poisoning, Trauma to skeletal muscles, Acute infection of liver or hepatitis.

SERUM TRANSAMINASES-SGOT (REITMAN & FRANKEL METHOD)


PRINCIPLE:
GOT (AST) - Glutamate oxaloacetate transaminases or

aspartate transaminase catalyses the transfer of an amino group from l- aspartate to - ketoglutarate resulting in the formation of pyruvate and L-glutamate respectively. Pyruvate so formed, couples with 2, 4, DNPH in an alkaline medium to form a brown coloured hydrazone complex. The intensity of the brown colour is proportional to SGOT (AST) activity and is measured photometrically.

L-aspartate + - ketoglutarate

oxaloacetate.

L-glutamate +

Blank

4 0.30 0.20 0.10 -0.50

Test 0.50 --0.10 0.50

GOT Substrate 0.50 0.45 0.40 0.35 Std. Sodium Pyruvate (ml) -- 0.05 0.10 0.15 D/W (ml) 0.10 0.10 0.10 0.10 Serum Sample --- --DNPH reagent (ml) 0.50 0.50 0.50 0.50

Mix thoroughly and keep at RT for 20 min. 0.4N NaOH (ml) Karmen Units 5.0 5.0 5.0 5.0 5.0 0.0 27.0 61.0 114.0 190.0 5.0

Mix and keep at room temperature for 10 min. Absorbance at 530 nm Draw a curve of Karmen units on X axis versus absorbance on Y axis and determine concentration of GOT.

The graph is not linear but a curve as the O.D increases with increase in enzyme activity at a decreasing rate.
Normal value: 8 40 U/L Clinical significance: SGOT- Myocardial infarction, carbon tetrachloride poisoning, Trauma to skeletal muscles, renal diseases.

You might also like