From the Guidelines
Yes, liver function tests (LFTs) are typically elevated in biliary cirrhosis, with a notable increase in alkaline phosphatase (ALP) and gamma-glutamyl transferase (GGT) due to cholestasis and bile duct obstruction. In biliary cirrhosis, the liver's bile ducts are damaged, leading to a buildup of bile and subsequent elevation of cholestatic enzymes like ALP and GGT 1. These enzymes are often elevated in conditions affecting the liver's bile ducts, including cirrhosis, primary biliary cholangitis, and primary sclerosing cholangitis. The elevation of ALP and GGT in biliary cirrhosis reflects the underlying pathophysiology of the disease, where the bile ducts are obstructed, leading to cholestasis and progressive liver damage. Some key points to consider in biliary cirrhosis include:
- Elevated ALP and GGT are hallmark laboratory findings in biliary cirrhosis, indicating cholestasis and bile duct obstruction 1
- Aminotransferases (ALT and AST) may also be mildly to moderately elevated, though usually not as prominently as the cholestatic markers 1
- Bilirubin levels often remain normal in early disease but rise as the condition progresses to advanced stages
- Laboratory monitoring of LFTs is essential for diagnosis, assessing disease severity, and monitoring response to treatments. It is essential to note that the elevation of these enzymes can be seen in various liver diseases, and a comprehensive diagnostic workup is necessary to determine the underlying cause of abnormal LFTs 1.
From the FDA Drug Label
Cholestyramine resin has been shown to have a variable effect on serum cholesterol in these patients. Patients with primary biliary cirrhosis may exhibit an elevated cholesterol as part of their disease.
Liver Function Tests (LFTs) are not directly mentioned in relation to biliary cirrhosis in the provided text. However, it is mentioned that patients with primary biliary cirrhosis may exhibit an elevated cholesterol as part of their disease.
- The text does not provide information on LFTs in biliary cirrhosis.
- It only mentions the potential for elevated cholesterol in these patients. The FDA drug label does not answer the question.
From the Research
Liver Function Tests in Biliary Cirrhosis
- Liver function tests (LFTs) are used to assess the many functions of the liver and to evaluate patients with suspected or established liver disease 2.
- In biliary cirrhosis, LFTs are consistent with cholestasis and reveal an elevation of serum alkaline phosphatase and gamma-glutamyl transpeptidase with or without elevation of aminotransferase levels 3.
- Elevated levels of alkaline phosphatase and bilirubin are associated with clinical outcomes in patients with primary biliary cirrhosis (PBC) and can be used as surrogate end points to monitor disease progression and evaluate potential treatments 4.
Elevation of LFTs in Biliary Cirrhosis
- The serological hallmark of PBC is the presence of antimitochondrial antibodies, which are found in 95% of patients with PBC, and LFTs are consistent with cholestasis 3.
- Levels of alkaline phosphatase and bilirubin measured at study enrollment and each year for 5 years were strongly associated with clinical outcomes in patients with PBC 4.
- Combining levels of alkaline phosphatase and bilirubin increased the ability to predict patient survival times in PBC 4.
Role of LFTs in Diagnosis and Monitoring
- LFTs are critical in recognizing the presence of liver disease and its specific diagnosis, but the interpretation of the tests may be confusing and difficult 5.
- A broad array of biochemical tests are used to assess the many functions of the liver and to evaluate patients with suspected or established liver disease 2.
- Abnormal LFTs may be the first indication of subclinical liver disease and may guide further diagnostic evaluation 2.