From the Guidelines
5'-nucleotidase testing is a crucial diagnostic tool for evaluating liver function and differentiating causes of elevated alkaline phosphatase (ALP) levels, particularly in patients with suspected hepatobiliary disease, as recommended by the most recent study 1. To perform the test:
- A blood sample is drawn from the patient.
- The sample is analyzed in a laboratory using spectrophotometric or radiometric methods.
- Results are typically available within 1-3 days. Normal range: 0-15 U/L (units per liter) for adults, though exact reference ranges may vary slightly between laboratories. Elevated 5'-nucleotidase levels, especially when accompanied by high ALP, suggest liver disease or bile duct obstruction, as noted in the study 1. This test is particularly useful because 5'-nucleotidase is more specific to the liver than ALP, which can also be elevated due to bone disorders. Common conditions associated with elevated 5'-nucleotidase include:
- Hepatitis
- Cirrhosis
- Liver cancer
- Bile duct obstruction The test helps differentiate liver issues from other causes of elevated ALP, such as bone diseases or pregnancy, and is often ordered alongside other liver function tests, including gamma-glutamyl transferase (GGT) testing and glutamate dehydrogenase (GLDH) testing, for a comprehensive evaluation of liver health, as recommended by the study 1. In clinical practice, 5'-nucleotidase testing should be considered in patients with elevated ALP levels to determine the underlying cause and guide further management, as suggested by the study 1.
From the Research
Definition and Purpose of 5 Nucleotidase Testing
- 5 nucleotidase testing is a diagnostic tool used to assess liver function and detect hepatobiliary diseases 2, 3, 4, 5.
- The test measures the level of 5 nucleotidase enzyme in the blood, which is elevated in cases of liver disease, particularly in obstructive jaundice, parenchymal liver disease, and hepatic metastases 4.
Comparison with Other Liver Function Tests
- 5 nucleotidase is more sensitive and specific than alkaline phosphatase in diagnosing hepatobiliary disorders 2, 3, 5.
- The test is useful in distinguishing between different types of liver disease, such as viral hepatitis, alcoholic liver disease, and liver cirrhosis 4.
- 5 nucleotidase levels are often compared with other liver function tests, such as aspartate and alanine aminotransferase, bilirubin, and alkaline phosphatase, to provide a comprehensive assessment of liver function 3, 6.
Clinical Applications
- 5 nucleotidase testing is used in the diagnosis of graft-versus-host disease in bone marrow transplant recipients 3.
- The test is also used to monitor liver function in patients with known liver disease and to detect liver damage in patients with other medical conditions, such as cancer, diabetes mellitus, and respiratory and cardiovascular diseases 2.
- In infancy, 5 nucleotidase testing is used to diagnose hepatobiliary disease, and is considered superior to alkaline phosphatase testing in this age group 5.