Serum enzymes associated with cholestasis

Sotil, Eva U.

doi:10.1016/s1089-3261(03)00136-3

Cited by 32 publications

(32 citation statements)

References 39 publications

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“…No ABCB4 mutation was found in these three patients, except the p.Arg652Gly variant, considered to be a neutral polymorphism, which was found in one of them. This isolated increase in serum GGT activity without other biological or clinical sign of chronic liver disease during follow-up may also be considered non-specific 27. According to our criteria of diagnosis, we found an exonic mutation in the ABCB4 gene in eight patients with ICP (16%).…”

Section: Discussionmentioning

confidence: 71%

ABCB4 gene mutations and single-nucleotide polymorphisms in women with intrahepatic cholestasis of pregnancy

Bacq

Gendrot

Perrotin

et al. 2009

Journal of Medical Genetics

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Section: Discussionmentioning

confidence: 71%

ABCB4 gene mutations and single-nucleotide polymorphisms in women with intrahepatic cholestasis of pregnancy

Bacq

Gendrot

Perrotin

et al. 2009

Journal of Medical Genetics

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“…25 The typical clinical parameters used for these purposes 14,15 are compiled in Table 3. Unfortunately, most of these parameters are not specific to liver disease and can also be influenced by physiological and lifestyle factors (age, sex, diet, consumption of alcohol and/or tobacco, etc.)…”

Section: Correlation With Clinical Parametersmentioning

confidence: 99%

Isotopic analysis of Cu in blood serum by multi-collector ICP-mass spectrometry: a new approach for the diagnosis and prognosis of liver cirrhosis?

et al. 2015

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The isotopic composition of blood serum Cu has been investigated as a potential parameter for the diagnosis and prognosis of liver cirrhosis. Serum samples from supposedly healthy women (reference population) and from a group of female patients suffering from liver cirrhosis of different etiologies were analysed. The procedure for isolation of serum Cu and the measurement protocol for its isotopic analysis by multi-collector inductively coupled plasma-mass spectrometry (MC-ICP-MS) were evaluated. Significant differences in the isotopic composition of Cu were observed between the reference population and the patients. A wide spread in δ(65)Cu was observed within the cirrhosis population and δ(65)Cu seems to be linked to the severity of the disease. Patients with end-stage liver disease showed a significantly lighter serum Cu isotopic composition. Many clinical parameters used for the diagnosis and monitoring of liver diseases, i.e. the levels of aspartate aminotransferase, De Ritis ratio, prothrombin and international normalized ratio, albumin, bilirubin, Na and C-reactive protein, correlate well with the δ(65)Cu values, as did the ceruloplasmin level and the ceruloplasmin/Cu concentration ratio. The isotopic composition of serum Cu appears to reveal the synthetic and hepatocellular function of the liver synergistically with inflammation and fluid retention in the cohort studied. A relevant relationship was also observed between δ(65)Cu and scores of mortality risk, such as the Model for End-stage Liver Disease (MELD) and MELD-Na. Thus, the isotopic composition of serum Cu shows potential as a new approach for the prognosis of liver disease, and although further investigation is required, for evaluation of the mortality risk in end-stage liver disease and prioritization of liver transplants.

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“…The mechanism underlying the elevation of GGT in hepatobiliary diseases remains uncertain, but solubilization and release of membrane-bound GGT is one possible mechanism. Alternatively, death of biliary epithelial cells is another possibility [54].…”

Section: Gamma-glutamyltransferasementioning

confidence: 99%

Laboratory Tests

Herlong

Mitchell

2011

Schiff's Diseases of the Liver

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Key conceptsr Biochemical tests can be used to detect acute injury to the liver and chronic diseases of the liver before development of symptoms.r Elevations in serum levels of aminotransferases (aspartate aminotransferase and alanine aminotransferase) reflect hepatocellular injury and/or permeability of the liver cell membrane, but do not correlate with the extent of fibrosis or measures of metabolic functions of the liver.r An elevation of serum alkaline phosphatase occurs in response to intrahepatic cholestasis, extrahepatic obstruction of bile ducts, or infiltration of the liver with granulomatous inflammation, amyloidosis, or venous congestion.r The rate-limiting step in metabolism and disposition of bilirubin is the transport of conjugated bilirubin from the hepatocyte into the bile.An elevation in the conjugated (direct-reacting) fraction of bilirubin is evidence of intrahepatic cholestasis or extrahepatic obstruction of the bile ducts.r Serum levels of albumin may be low in patients with acute or chronic liver disease, but very often drop in response to the "acute phase response," making it difficult to evaluate hepatic metabolic function in clinical situations such as infection.r Although single laboratory tests are generally not useful in evaluating the severity of acute or chronic liver diseases, the use of mathematical equations combining tests may be effective as surrogate markers for the extent of fibrosis, steatosis, and inflammation as well as to predict the short-term prognosis in patients with liver disease.The use of laboratory tests is an important component of the assessment of patients with liver disease. With increasing frequency, elevations in the hepatic enzymes detected on routine screening tests provide the first evidence of liver disease in otherwise asymptomatic patients. In those patients with previously recognized hepatic dysfunction, laboratory tests can help establish the etiology of liver disease and provide valuable prognostic information. Rarely does a single test provide sufficient information to establish a diagnosis or assess severity of liver disease. A combination of tests such as serum bilirubin, albumin, aminotransferases, and alkaline phosphatase is sometimes referred to "liver function tests" or a "liver panel." These tests, in combination with the prothrombin time can provide an initial characterization of the etiology and severity of liver disease. However, one should recognize that the aminotransferases and alkaline phosphatase are tests that reflect hepatic injury not function. Traditionally liver diseases have been characterized as primarily hepatocellular or cholestatic based on the predominance of elevated aminotransferases or alkaline phosphatase. While an individual laboratory test may not provide a specific diagnosis, the pattern of abnormalities can suggest a general category of hepatic dysfunction. Although this distinction helps direct the initial evaluation there is often considerable overlap so that aggregating the diseases is less useful, as in the case...

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Serum enzymes associated with cholestasis

Cited by 32 publications

References 39 publications

ABCB4 gene mutations and single-nucleotide polymorphisms in women with intrahepatic cholestasis of pregnancy

ABCB4 gene mutations and single-nucleotide polymorphisms in women with intrahepatic cholestasis of pregnancy

Isotopic analysis of Cu in blood serum by multi-collector ICP-mass spectrometry: a new approach for the diagnosis and prognosis of liver cirrhosis?

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