From the Guidelines
For diffuse hepatic hemangiomas, the recommended serum lab tests include liver function tests (LFTs), such as alanine aminotransferase (ALT), aspartate aminotransferase (AST), and alkaline phosphatase (ALP), as these tests can detect liver damage and impairment caused by the hemangiomas 1.
Recommended Serum Laboratory Tests
- Liver function tests (LFTs), including:
- Alanine aminotransferase (ALT)
- Aspartate aminotransferase (AST)
- Alkaline phosphatase (ALP)
- Total and direct bilirubin
- These tests are essential in evaluating liver function and detecting any impairment caused by the hemangiomas, as hepatocellular predominant abnormal liver function tests are reflected as an increase in aminotransferases, ALT, and AST 1.
Additional Tests to Consider
- Complete blood count (CBC) to assess for anemia or thrombocytopenia, which can occur in large hemangiomas (Kasabach-Merritt syndrome)
- Coagulation profile (PT, INR, aPTT) to assess for any coagulopathy associated with large hemangiomas
- Alpha-fetoprotein (AFP) to rule out hepatocellular carcinoma, which can sometimes be confused with hemangiomas
- Serum albumin, blood urea nitrogen (BUN), and creatinine to provide information on overall liver synthetic function and renal status
Justification
- The recommended tests help in monitoring the progression of the disease, assessing liver function, and detecting any complications, as well as differentiating hemangiomas from other liver lesions and guiding treatment decisions 1.
- The tests should be performed initially and then monitored periodically, typically every 6-12 months or as clinically indicated, to ensure timely detection of any changes in liver function or disease progression.
From the Research
Serum Laboratory Tests for Diffuse Hepatic Hemangiomas
The following serum laboratory tests are used to evaluate liver function and may be relevant in the context of diffuse hepatic hemangiomas:
- Serum bilirubin 2, 3, 4, 5
- Alanine amino transferase (ALT) 2, 3, 4, 5
- Aspartate amino transferase (AST) 2, 3, 4, 5
- Alkaline phosphatase (ALP) 2, 3, 4, 5
- Gamma glutamyl transferase (GGT) 2, 3, 4
- Albumin levels 3, 4, 5
- Prothrombin time 3, 4
- AST/ALT ratio 3, 5
Rationale for Test Selection
These tests are commonly used to assess liver function and injury, and may be useful in evaluating patients with diffuse hepatic hemangiomas 2, 3, 4. The selection of tests may depend on the clinical presentation and suspected underlying liver disease 3, 4.
Additional Tests
Other tests, such as indocyanine green (ICG) test, LiMAx test, and imaging-based liver function tests, may also be used to assess liver function in certain situations 4, 6. However, these tests may not be directly relevant to the diagnosis of diffuse hepatic hemangiomas.