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Evaluation of abnormal liver function tests
  1. Swastik Agrawal1,
  2. Radha K Dhiman1,
  3. Jimmy K Limdi2,3
  1. 1Department of Hepatology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
  2. 2Department of Gastroenterology, The Pennine Acute Hospitals NHS Trust, Manchester, UK
  3. 3Honorary Senior Lecturer- Institute of Inflammation and Repair, Manchester Academic Health Sciences Centre, University of Manchester, Manchester, UK
  1. Correspondence to Dr Jimmy K Limdi, Department of Gastroenterology, The Pennine Acute Hospitals NHS Trust, 2.41 Fairfield House, Jericho Road, Bury, Manchester BL97TD, UK; Jimmy.limdi{at}


Incidentally detected abnormality in liver function tests is a common situation encountered by physicians across all disciplines. Many of these patients do not have primary liver disease as most of the commonly performed markers are not specific for the liver and are affected by myriad factors unrelated to liver disease. Also, many of these tests like liver enzyme levels do not measure the function of the liver, but are markers of liver injury, which is broadly of two types: hepatocellular and cholestatic. A combination of a careful history and clinical examination along with interpretation of pattern of liver test abnormalities can often identify type and aetiology of liver disease, allowing for a targeted investigation approach. Severity of liver injury is best assessed by composite scores like the Model for End Stage Liver Disease rather than any single parameter. In this review, we discuss the interpretation of the routinely performed liver tests along with the indications and utility of quantitative tests.

  • liver function

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