Evaluation of which one of the following serum levels helps in distinguishing an acute liver disease from chronic liver disease?
Serum albumin is synthesized exclusively by hepatocytes. It has a long half-life of 18-20 days, and has a slow turn over. Because of this slow turnover, it is not a good indicator of acute or mild hepatic dysfunction, only minimal changes in the serum albumin are seen in acute liver conditions. Hypoalbuminemia is more common in chronic liver disorders such as cirrhosis and usually reflects severe liver damage and decreased albumin synthesis. So it is useful in differentiating acute and chronic liver disease. Albumin levels are increased in dehydration, shock and hemoconcentration. It is decreased in chronic liver disease, malnutrition, malabsorption, malignancy (decreased production), nephrotic syndrome, burns, trauma, hemorrhage with fluid replacement, fistulas, enteropathy, acute or chronic glomerulonephritis (increased loss), pregnancy and CHF (hemodilution). Ref: Pocket Guide to Diagnostic Tests, 5th Edition; Harrison's Internal Medicine, 18th Edition, Chapter 302
Albumin
Bilirubin
Aminotransaminase
Alkaline phosphatase