Liver enzyme alteration: a guide for clinicians

[mike716]

For those who, like me, aren't satisfied with what doctors tell us and want to delve more deeply into things than patients usually do (or are supposed to :]), here's a free download of a detailed review article, with references, on all those confusing liver enzymes and other blood tests:

http://www.cmaj.ca/cgi/reprint/172/3/367

[mike716]

You are most welcome ;-]

[CockSparrow]

Excellent article. Thanks for posting
CS

[mike716]

Glad it was some use to you. That article is like a mini-course in how the liver works and how HCV can mess it up. I thought it was super.

Mike

[mike716]

Maybe this will help, Mary. It's a quote from the last part of the article (the Conclusions):

"Alterations in liver enzyme levels are one of the most
common problems encountered in everyday clinical practice.
Finding the way through the multiple diagnostic
pathways can challenge even the experienced clinician.
Knowledge of the pathophysiology of liver enzymes is an
essential guide to understanding their alteration. The pattern
of enzyme abnormality, interpreted in the context of
the patient’s characteristics, can aid in directing the subsequent
diagnostic work-up."

Translation: If you're gonna give patients these tests, you oughtta know what they mean.

[wink]

Mike

[mike716]

Gee, I'm very sorry it scared you, Mary. Maybe I shouldn't post links to articles meant for doctors and researchers, but this one seemed pretty readable to me. It's impossible to summarize it, though, since it's a detailed analysis of how to interpret all the blood test markers and what they might mean ("might" being the key word here, I think, since none of them is conclusive).

If I had to sum up the whole article in one sentence, I'd say that the blood test markers like AST, ALT, bilirubin, GGT, creatinin, prothrombin time, and all the rest related to HCV, can actually give clinical doctors who pay close attention to them a fairly good idea of the status of a patient vis-a-vis the virus and the state of his/her liver.

This is in marked contrast with the usual gaff we get from doctors about their not being able to tell much of anything from the blood tests. It's an important point, because life-dependent decisions are being made at every step of the patient-doctor process, like who gets antiviral therapy, when they get it, how long they get it, and even if they should get it. Also, the article shows that there's a logical sequence that should be followed in the testing of patients, like in any investigation, and if the doctor doesn't really understand the importance of the test results he /she can't make the right decisions regarding what test to give next.

A long-winded answer. Maybe it's enough to just say that the article was written for doctors to help them interpret the tests. Why should patients be kept in the dark?

Mike

[debnevada]

excellent article.  it actually helps with my law suit!

[Mary4now]

All I did was get myself scared, and I cant pretend I understand what that article said.  Can you do the work for me and give me the gist.