ProceeDiNgsboek - Universiteit Utrecht
ProceeDiNgsboek - Universiteit Utrecht
ProceeDiNgsboek - Universiteit Utrecht
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How to interpret?<br />
• Hepatocyte (parenchymal) damage: ALT<br />
– Hepatitis (tumor, hypoxia, toxicity, etc.)<br />
• Cholestasis: AP, γGT, GT, Bile acids<br />
– Intra/extrahep bile duct disease, non specific<br />
reactive hepatitis<br />
• Portosystemic shunting: NH3 and bile<br />
acids<br />
– Congenital shunts, portal hypertension<br />
• Very specific<br />
Bile acids<br />
– Clearance from plasma<br />
– Conjugation<br />
– Excretion<br />
– Transport<br />
enterohepatic circulation<br />
Summary blood screen for liver<br />
disease<br />
• Combine enzymes with bile acids<br />
• Combination AP, ALT and bile acids works<br />
always<br />
– All normal: no liver disease<br />
– One or more abnormal: liver disease<br />
• Primary or secondary<br />
• Portosystemic shunting: NH3<br />
8
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