What Causes an Abnormal Liver Function Test?

Hepatic Insufficiency is when the liver is damaged by certain pathogenic factors, which causes the destruction of liver morphology and structure and abnormal liver function. Mild damage, through the liver's compensatory function, generally does not occur obvious dysfunction; if the damage is more serious and extensive, it will cause obvious liver metabolism disorders, reduced detoxification function, bile formation and excretion disorders, and bleeding tendency Dysfunction changes, called liver dysfunction, that is, liver dysfunction.

Basic Information

English name: Hepatic Insufficiency
Visiting department: Gastroenterology
Common locations: liver
Common causes: Infections, chemical poisoning, abnormal immune function, insufficient nutrition, biliary obstruction, blood circulation disorders, tumors, genetic defects, etc.

Common symptoms: Loss of appetite, nausea and vomiting; fatigue, lethargy; jaundice; fatty liver; peritoneal effusion, pleural effusion; rough skin, night blindness; bleeding gums; spider mole, liver palm

Causes of abnormal liver function

Infection

Parasites (Schistosoma, Schistosoma sinensis, Amoeba), Leptospira, bacteria, and viruses can cause liver damage. Among them, viruses are the most common (such as viral hepatitis).

2. Chemical poisoning

Such as carbon tetrachloride, chloroform, phosphorus, antimony, arsenic, etc., can often destroy the liver cell enzyme system, cause metabolic disorders, or inhibit the oxidative phosphorylation process, leading to degeneration and necrosis of liver cells; some drugs, such as chloropropyl Azine, parasalic acid, certain iodimine drugs, and antibiotics (such as tetracycline), even at therapeutic doses, can cause liver damage in a small number of people, which may be related to allergies.

3. Immune dysfunction

Liver disease can cause abnormal immune response, which is one of the important reasons for liver damage. For example, humoral and cellular immunity caused by hepatitis B virus can damage liver cells; surface antigens, core antigens, and e antigens of hepatitis B virus can bind to the surface of liver cells, change the antigenicity of liver cell membranes, and cause autoimmunity. Another example is primary biliary cirrhosis. There are multiple antibodies in the patient's blood (anti-small bile duct antibodies, anti-mitochondrial antibodies, anti-smooth muscle antibodies, anti-nuclear antibodies, etc.), and it may also be an autoimmune disease.

4. Inadequate nutrition

Lack of choline and methionine can cause liver steatosis. This is because the transport of liver fats must first be converted to phospholipids (mainly lecithin), and choline is an essential component of lecithin. Methionine supplies methyl groups that synthesize choline. When these substances are lacking, the removal of fat from the liver is hindered, causing steatosis of the liver.

5. Biliary obstruction

Bile duct obstruction (such as stones, tumors, tapeworms, etc.) causes cholestasis. If it is too long, it can cause liver ischemia due to the damage of bile on liver cells and the expansion of bile ducts in the liver, causing hepatic ischemia due to sinusoidal compression. Degeneration and necrosis.

6. Blood circulation disorders

Such as chronic heart failure, cause liver congestion and hypoxia.

7. Tumor

Such as liver cancer damage to liver tissue.

8. Genetic defects

Some liver diseases are genetic diseases caused by genetic defects. For example, because the liver is unable to synthesize ceruloplasmin, which causes copper metabolism to be disrupted, which causes degeneration of the hepatolenticular nucleus; liver cells lack a 1-phosphate glucose galactose uridine transferase, and galactose 1-phosphate cannot be converted to 1-phosphate Accumulation of glucose can damage liver cells and cause cirrhosis.

Clinical manifestations of abnormal liver function

Digestive dysfunction, causing loss of appetite, liver dysfunction, oiliness, nausea, vomiting, etc .; liver cell damage, which increases serum transaminase and other enzymes, and reduced cholinesterase, which can cause fatigue, fatigue, lethargy, etc .; bile Abnormal metabolism of red pigment can cause jaundice; Impaired glucose metabolism can cause changes in blood lipid content, reduced cholesterol synthesis and esterification ability; Impaired fat metabolism can form fatty liver; Impaired albumin synthesis, which can lead to peritoneal effusion, pleural effusion, etc. in severe cases; Vitamin metabolism disorders can cause rough skin, night blindness, lip and tongue inflammation, edema, skin bleeding, osteoporosis, etc .; clotting factor synthesis disorders can cause gum bleeding, nose bleeding, etc .; abnormal hormone metabolism can cause hyposexuality, menstrual disorders , Skin arteriolar dilatation, spider moles, liver palms, dark complexion and so on.

Liver function test

1. Liver cell damage, resulting in increased serum transaminase and other enzymes, and reduced cholinesterase.

2. Bile pigment metabolism abnormalities can cause jaundice.

3. Impaired glucose metabolism can cause changes in blood lipid content, reduced cholesterol synthesis and esterification ability.

4. Fatty metabolism disorders can form fatty liver.

5. Impaired albumin synthesis can cause albumin / globulin inversion.

6. Vitamin metabolism disorders, can cause rough skin, night blindness, inflammation of the lips and tongue, osteoporosis and so on.

7. Coagulation factor synthesis disorders can cause gum bleeding, nosebleeds, etc.

8. Abnormal hormone metabolism can cause hyposexuality, menstrual disorders, spider moles, liver palms, etc.

Differential diagnosis of liver dysfunction

Viral hepatitis, drug-induced hepatitis, fatty liver, toxic hepatitis, liver congestion, liver tumors, etc. can cause abnormal liver function, and should be identified based on its etiology, clinical manifestations, and related examinations.

Treatment of abnormal liver function

If abnormal liver function is found, the patient must make a comprehensive examination in time to find out the specific cause, and adopt different treatment methods for different manifestations and causes, such as symptomatic treatment such as liver protection, yellowing, antiviral, lipid lowering, Symptoms and symptoms. If the liver function is abnormal due to hepatitis B, cirrhosis, fatty liver and other disease factors, timely symptomatic treatment is required. If the liver function is abnormal due to factors such as drinking, overwork, staying up late, obesity, taking drugs, etc., it is necessary to adjust in time, pay attention to rest and a reasonable diet, and it is expected to return to normal. Do not blindly take medical drugs when liver function is abnormal, such as obese and overweight people need to check blood lipids and B-ultrasound to understand the presence of fatty liver; patients with tuberculosis should consider drug-induced liver damage. Not all liver dysfunctions need to be treated with drugs, such as transient aminotransferase elevations caused by strenuous exercise, fatigue, poor sleep, etc., often they can recover without medication, and specific reasons need to be analyzed. If liver function is abnormal and accompanied by severe digestive tract symptoms, you must go to a liver disease specialist immediately for treatment. If liver function is abnormal due to active replication of HBV and HCV, early antiviral therapy is expected to achieve long-term stability.