Which one of the following serum levels would help in distinguishing an acute liver disease from chronic liver disease?
Answer is D (Albumin) Only minimal changes in serum albumin are seen in acute liver conditions. Hypoalbuminemia is common in chronic liver disorders such as cirrhosis. In hepatitis serum albumin levels of less than 3g/dl (hypoalbuminemia) should raise the possibility of chronic liver disease' Albumin as marker for liver dysfunction Serum albumin is synthesized exclusively by hepatocytes Serum albumin has a long half life and is degraded very slowly (approx 4% is degraded per day.) Because of this slow turnover, the serum albumin is not a good indicator of acute hepatic dysfunction. Acute liver conditions are associated with only minimal changes in serum albumin (Albumin levels may be normal or minimally altered in viral hepatitis drug related hepato-toxity and obstructive jaundice) Chronic liver conditions are associated with hypoalbuminemia reflecting decreased albumin synthesis from severe and prolonged liver dysfunction. Remember: Hypoalhuntinemia is not specific for liver disease and may occur in protein malnutrition of any cause, protein losing enter apathies nephritic syndrome and chronic infections. Aminotransferases are used as indicators of extent of hepatocellular injury. They may be elevated in both acute and chronic hepatocellular disorders. Alkaline phosphatase is an enzyme used as markers of cholestasis and again may be elevated in both acute and chronic cholestatic disorders. Bilirubin levels also may be elevated in both acute and chronic liver disease.
Aminotransaminase.
Alkaline phosphatase
Bilirubin.
Albumin