Albumin liver function test

In patients with a history of AED use, a baseline serum concentration may be useful to determine if the drug concentration is below the desired range and if a loading dose is needed. Albumin levels, renal function tests, and liver function tests can also be helpful when assessing antiepileptic therapy. 

A complete physical examination and laboratory analysis are needed to rule out secondary causes and to assess kyphosis and back pain. Laboratory testing may include complete blood count, liver function tests, creatinine, urea nitrogen, calcium, phosphorus, alkaline phosphatase, albumin, thyroid-stimulating hormone, free testosterone, 25-hydroxyvitamin D, and 24-hour urine concentrations of calcium and phosphorus. Urine or serum biomarkers (e.g., cross-linked N-telopeptides of type 1 collagen, osteocalcin) are sometimes used. 

Current nutritional intake Complete blood cell count Serum electrolytes Sodium Potassium Chloride Bicarbonate Magnesium Phosphorous Calcium Serum glucose Serum albumin Markers for organ function Liver function tests Alkaline phosphatase Aspartate aminotransferase Alanine aminotransferase Total bilirubin Prothrombin time or International normalized ratio Renal function tests Blood urea nitrogen Creatinine Fluid balance Input Oral... 

Transient liver function test abnormalities are observed frequently after methotrexate administration and are usually not cause for modification of therapy. Persistent liver function test abnormalities and/or depression of serum albumin may be indicators of serious liver toxicity and require evaluation. 

Periodically perform liver function tests, including serum albumin, prior to dosing. 

Biochemical effects of interleukin-6 included asymptomatic increases in liver function tests, transient proteinuria, and increased serum creatinine concentrations. Reductions in serum albumin and cholesterol concentrations, and increases in blood glucose concentrations were dose-related (SEDA-21, 376) (2). 

A 23-year-old Asian butcher developed diffuse abdominal pain, vomiting, and diarrhea, followed by constipation (4). He had a sinus tachycardia and generalized abdominal tenderness without peritonism. His serum bilirubin concentration and alanine transaminase activity were raised, but alkaline phosphatase activity, albumin concentration, and prothrombin time were normal. He had a blood lead concentration of 767 ng/ml and a raised zinc protoporphyrin concentration, diagnostic of lead poisoning. He had taken an herbal medicine, purchased in India, for vague aU-ments. He stopped taking it, and 3 months later was asymptomatic, with normal liver function tests and marked falls in blood lead (387 ng/ml) and zinc protoporphyrin. 

Analbuminemia is a rare autosomal recessive disorder. Affected individuals do not exhibit serious clinical symptoms, not even edema. The lack of clinical edema is presumably due to osmotic compensation by the mildly elevated globulins. Osteoporosis in analbuminemia has been corrected by the administeration of human serum albumin. Affected females exhibit minimal pretibial edema, mild anemia, normal liver function tests, absence of proteinuria, lowered blood pressure, elevated serum cholesterol levels, and lipodystrophy. Despite elevated plasma cholesterol levels, severe atherosclerosis was not present. 

Routine liver tests include alkaline phosphatase, bilirubin, aspartate transaminase (AST), alanine transaminase (ALT), and y-glutamyl transpeptidase (GGT). Additional markers of hepatic synthetic activity include albumin and prothrombin time. Liver function tests are... 

The use of liver function tests in the diagnosis and management of cirrhosis is discussed in the following sections. It may be useful to group the tests into two broad categories markers of hepatocyte damage such as the transaminases and markers of hepatocellular synthetic function, prothrombin time and albumin. 

Elevated liver enzymes may occur in up to 15% of patients cirrhosis is rare. Liver function tests, aspartate aminotransferase (AST) or alanine aminotransferase (ALT), should be performed periodically. Methotrexate should be discontinued if these test values show sustained results greater than twice the upper limits of normal. Serum albumin levels also should be checked periodically, as signs of liver toxicity in some patients may not have liver inflammation manifested by AST or ALT elevation. Liver biopsy is now recommended before beginning methotrexate therapy only for patients with a history of excessive alcohol use, ongoing hepatitis B or C infection, or recurring elevation of AST. Biopsies during methotrexate therapy are recommended only for patients who develop consistently abnormal liver function tests. ... 

Serum albumin and liver function tests should be measured to detect liver disease. 

What are usually called liver function tests (LFTs) do not a.ssess quantitatively the capacity of that tissue to carry out any of the functions which are described above. T.FTs are measurements of blood components w hich simply provide a lead to the existence, the extent and the type of liver damage. Usually, a request for LFTs will provide results for bilirubin, the aminotransferases and alkaline phosphatase in a serum specimen. Know ledge of the serum albumin concentration may also be of some value in the investigation of liver disease. These biochemical investigations cun assist in differentiating the follow ing ... 

Blood tests including complete blood count, liver function tests, creatinine, albumin, prothrombin activity, and alpha-fetoprotein. 

In the presence of subtle or minor changes in liver function tests, it is difficult to distinguish liver toxicity from tumor progression or variation in liver function tests commonly occurring among cirrhotic patients. However, liver function worsened in some patients 2-3 months after RE. RE-induced liver injury usually appeared as ascites, increased serum bilirubin, and decreased serum albumin... 

I. Lundberg, G. Nise, G. Hedenberg, M. Hogberg, and O. Vesterberg, Liver function tests and urinary albumin in house painters with previous heavy exposure to organic solvents, Occup. andEnviron. Med.,51, 347 (1994). 

The viability and function tests described above are used to evaluate the hepatocytes within the slice. Up to now, tests to measure the viability of the non-parenchymal cells have not been reported. The presence of the latter cell types is one of the conceptual advantages of slices as compared to isolated hepatocytes. As some drug targeting devices are designed to target non-parenchymal cells in the liver, the development of tests for the sinusoidal cell types deserves more attention. For example, the uptake of substrates such as succinylated human serum albumin (Suc-HSA,which is specifically endocytosed by endothelial cells [79]), or hyaluronic acid [80], can be used to assess the functionality of endocytotic pathways in the endothelial cells in the liver [81]. Other modified proteins that are specifically taken up by Kupffer cells such as mannosylated HSA, may be used to assess the functionality of the endocytotic pathway in Kupffer cells [79]. Another parameter which can be used to assess the functionality of these non-parenchymal liver cells, is the excretion of cytokines in response to pro-inflammatory stimuli. Non-parench5mal cell function in liver slices will be described in more detail in the Section 12.7. 

The compensated stage does not usually display any signs of liver insufficiency (except possibly jaundice), nor are there any typical ailments. Functional parameters that can be quantified in routine laboratory tests (such as cholinesterase, albumin. Quick s value, bile acids) may still be normal or only minimally impaired in the individual instance. In contrast, liver tolerance tests (galactose, indocyanine green, etc.) demonstrate a reduction of liver function which is already quite considerable. 

Several multianalyte diagnostic methods have been marketed to assess the level of liver fibrosis, such as Fibroscan and Fibrotest.39 These tests may leave room for improved biomarkers however, the accuracy of the biopsy method has also been questioned as a source of error in evaluation of these studies. Additional liver biomarkers are needed that improve on the specificity of ALT to differentially diagnose injury severity, or improve on the sensitivity of serum bilirubin or serum albumin and clotting factors to help assess liver function. 

The cholinesterases are generally accepted as being synthesized in the liver, and the assay of cholinesterase first became of interest to the clinician and to the clinical chemist as a test of liver function. Low serum cholinesterase activities are found in acute hepatitis, acute cirrhosis, and in liver metastases—that is, in those conditions where the hepatic synthesis of the protein is impaired. The synthesis of several other proteins is also reduced in such conditions, so that cholinesterase assay has been largely superseded as a test of liver function by measurements related to such proteins as albumin and prothrombin. Nevertheless, cholinesterase still has a place in the assessment of hepatic and other diseases, as discussed in Section 5.2. 

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