1 / 17

MLAB 2401: Clinical Chemistry Keri Brophy-Martinez

MLAB 2401: Clinical Chemistry Keri Brophy-Martinez. Alterations in Liver Function. Jaundice/Icterus. Yellow discoloration of the skin, eyes and mucous membranes Due to the presence of bilirubin Onset seen at bilirubin levels > 3.0 mg/dL Kernicterus

margie
Download Presentation

MLAB 2401: Clinical Chemistry Keri Brophy-Martinez

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript


  1. MLAB 2401: Clinical ChemistryKeri Brophy-Martinez Alterations in Liver Function

  2. Jaundice/Icterus • Yellow discoloration of the skin, eyes and mucous membranes • Due to the presence of bilirubin • Onset seen at bilirubin levels > 3.0 mg/dL • Kernicterus • Yellow staining of the meninges of the brain due to bilirubin • Found in newborns • Causes brain damage

  3. Classification of Jaundice • Prehepatic • Hepatic • Posthepatic

  4. Classifications of Jaundice • Prehepatic • Abnormality is outside the liver • Liver function is normal • Cause: too much bilirubin presented to liver • Result • Increase in unconjugated bilirubin • Total bilirubin: increased or normal • Increase in serum iron • Examples: acute /chronic hemolytic anemias

  5. Classifications of Jaundice • Hepatic • Intrinsic liver disease or defect • Caused by • Disorders of bilirubin conjugation • Disorders of bilirubin transport • Hepatocellular injury or destruction • Cirrhosis • Tumors • Infection • Toxins • Intrahepatic obstructions

  6. Inherited Hyperbilirubinemias Liver • Gilbert Syndrome • Reduction in the activity of UDP-glucoronyltransferase • Crigler-Najjar syndrome • Defective UDPG-transferase • Dublin-Johnson disease • Post-conjugation failure

  7. Acquired Hyperbilirubinemias • Neonatal jaundice • Deficiency of glucuronyl transferase • Causes an increase in unconjugated bilirubin • Leads to kernicterus • Treat by exposure to UV light or exchange transfusion

  8. Classifications of Jaundice • Posthepatic • Abnormality is outside the liver • Liver function is normal • Biliary obstruction due to gallstones, tumors, edema • Stool turns clay-colored due to lack of bile • Results: • Increased: Conjugated bilirubin, urinary bilirubin, ALP, GGT, total bilirubin, unconjugated bilirubin • Decreased: Urine and fecal urobilinogen

  9. Other Liver Dysfunctions • Reye’s Syndrome • Cirrhosis • Drug & Alcohol Disorders • Hepatitis

  10. Reye Syndrome • Group of disorders caused by infectious, metabolic, toxic or drug-induced disease found mostly in children • Often preceded by viral syndrome • Related to aspirin consumption during the viral syndrome • Symptoms • Profuse vomiting • Neurological impairment

  11. Cirrhosis • Scar tissue replaces normal healthy liver tissue • As time moves forward, function deteriorates and signs appear • Fatigue, nausea, weight loss, jaundice, etc • Common causes • Chronic alcoholism • Hepatitis • Results: • Increased: unconjugated and conjugated bilirubin, ALP, GGT,AST, ALT • Decreased: cholesterol, albumin

  12. Drug and Alcohol Disorders • Accounts for 1/3 to ½ of acute liver failure since the liver plays a major role in drug metabolism • Drugs cause an immune mediated injury to the hepatocytes, resulting in disease • Ethanol is the most significant • Acetaminophen also common • Several stages of classification based on disease severity

  13. Alcoholic Liver Disease (ALD) • Breakdown of alcohol leads to toxin formation • Risk factors for ALD include: • History and magnitude of alcohol consumption • Hepatitis B or C infection • Gender • Genetic factors • Nutritional status

  14. Alcoholic Injury • Stages • Alcoholic Fatty Liver • Mildest form • Elevations of AST, ALT, GGT • Complete recovery possible if drug removed • Alcoholic hepatitis • Moderate elevations of AST, ALT, GGT • Bilirubin, ALP also elevated • Albumin decreased • PT prolonged • Alcoholic cirrhosis • Elevated AST, ALT, GGT, ALP, total bilirubin • Albumin decreased • PT prolonged

  15. Hepatitis • Inflammation of the liver • Viral, bacterial, radiation, drugs, chemicals and others can cause inflammation • Viral infections account for the majority of cases in the clinical lab • Includes subtypes A, B,C, D, and E • Clinical Symptoms • Jaundice, dark urine, fatigue, nausea, abdominal pain

  16. Hepatitis Viruses

  17. References • Bishop, M., Fody, E., & Schoeff, l. (2010). Clinical Chemistry: Techniques, principles, Correlations. Baltimore: Wolters Kluwer Lippincott Williams & Wilkins. • http://kidshealth.org/parent/pregnancy_center/newborn_care/jaundice.html • Sunheimer, R., & Graves, L. (2010). Clinical Laboratory Chemistry. Upper Saddle River: Pearson .

More Related