CC-Lab Liver Function Tests

What are the 3 Main Liver Function Tests?

Hepatic Synthesis Ability

Conjugation/Excretion Function

Detoxification Function

The Functions under Hepatic Synthesis Ability:

Total Protein Determination

Prothrombin Time

Albumin

The Functions under Conjugation/Excretion Function:

Bilirubin Assay

Bromosulfophthalein Test (BSP)

Urobilinogen

The Functions under Detoxification Function:

Enzyme Tests

Ammonia

What are the methods under Total Protein Determination:

• Kjeldahl Method

• Biuret Method

• Folin-Ciocalteu (Lowry) Method

• UV Absorption Method

• Electrophoresis

• Refractometry

• Turbidimetric/Nephelometric Methods

• Salt Fractionation

What are the methods under Albumin:

A/G ratio

What are the methods under Bilirubin Assay:

• Malloy-Evelyn Method

• Jendrassik-Grof Method

What are the methods under Bromosulfophthalein Test:

Dye Extraction Test

• Rosenthal White Method

• MacDonald Method

What are the methods under Urobilinogen:

Ehrlich Method

What are the methods under Enzyme Tests:

• ALP

• ALT

• AST

• 5’N

• GGT

• LAP

• LDH

What are the methods under Ammonia:

• Nesslerization Reaction (Brown compound)

• Berthelot Reaction (Blue compound)

Urine bilirubin reacts to diazotized sulfanilic acid to produce red azo dye (540 nm)

Classic Diazo reaction (Ehrlich, 1883)

Using serum

Used alcohol accelerator for the coupling of bilirubin to diazotized sulfanilic acid

Van den Bergh, 1913

Serum bilirubin

50% methanol

Malloy-Evelyn Method (1937)

Serum bilirubin

Caffeine-benzoate-acetate

Jendrassik-Grof Method (1938)

Terminates the reaction in caffeine-benzoate-acetate

Ascorbic acid

conjugated bilirubin binded to albumin

seen only in hepatic obstruction

Delta Bilirubin

Used in neonatal population

Measurement of reflected light from skin using two wavelengths

Bilirubinometry

provides numerical index based on spectral reflectance

Bilirubinometry

Yellowishness of the serum or plasma

0.01% potassium dichromate

Icterus Index

is the preferred specimen for Malloy-Evelyn

Serum

Addition of this may precipitate protein which leads to an interference.

Alcohol

True or False?
Fasting sample is preferred for Bilirubin Tests

True.

Should you protect the sample from light, if testing for Bilirubin? (Y/N)

Yes.

What is the reference value for conjugated bilirubin? (Adults)

0.0-0.2 mg/dL (0-3 umol/L)

What is the reference value for unconjugated bilirubin? (Adults)

0.2-0.8 mg/dL (3-14 umol/L)

What is the reference value for total bilirubin? (Adults)

0.2-1.0 mg/dL (3-17 umol/L)

What is the reference value for total bilirubin at 24h? (Premature infants)

1-6 mg/dL (17-103 umol/L)

What is the reference value for total bilirubin at 48h? (Premature infants)

6-8 mg/dL (103-137 umol/L)

What is the reference value for total bilirubin at 3-5 d? (Premature infants)

10-12 mg/dL (171-205 umol/L)

What is the reference value for total bilirubin at 24h? (Full-term infants)

2-6 mg/dL (34-103 umol/L)

What is the reference value for total bilirubin at 48h? (Full-term infants)

6-7 mg/dL (103-120 umol/L)

What is the reference value for total bilirubin at 3-5 d? (Full-term infants)

4-6 mg/dL (68-103 umol/L)