blood tests in biliary disease
Last reviewed 06/2021
- blood tests generally include:
- full blood count, urea and electrolytes, liver function test (LFT), calcium, albumin and international normalised ratio (INR)
- biliary disease typically produces a cholestatic picture – elevated alkaline
phosphatase (ALP) and gamma-glutamyl transferase (GGT) with variable abnormalities
of the transaminases (AST, ALT)
- in the early stages of biliary obstruction - ALT rises before the ALP;
cholestasis produces a conjugated hyperbilirubinaemia
- INR and albumin indicate the synthetic function of the liver - these are good indicators of severity of disease in conjunction with bilirubin
- in the early stages of biliary obstruction - ALT rises before the ALP;
cholestasis produces a conjugated hyperbilirubinaemia
If there are renal function abnormalities in the presence of liver disease then this generally indicates a worse prognosis.
Haematological investigations:
- leucocytosis with a neutrophilia if biliary sepsis
- anaemia of varying degrees may be present
- iron deficiency - if there has been chronic gastrointestinal blood loss
- macrocytosis - may occur secondary to alcohol abuse or small bowel diseases, eg bacterial overgrowth and parasitic infestations
Reference:
- Prescriber 2003; 14(23):20-9.