Fatima Zafar, Atifa Shoaib, Muhammad Umar.
Patterns of abnormal liver function tests in viral hepatitis.
Ann Pak Inst Med Sci Jan ;2(4):260-4.

Aims & Objectives: To study the patterns of abnormalities in liver function tests in patients suffering from hepatitis viruses A,B,C,D & E in the Rawalpindi region and the limitations of liver function tests(LFTs) in diagnosis of liver disease. Methods: This was a cross sectional study utilizing laboratory data for a period of 24 months (Jan 2004-Jan 2006). Data of 635 patients referred to our diagnostic center for workup of viral hepatitis along with LFTs was analyzed. Both males and females were included with the age range of 3 months to 80 years. The hepatitis virus screening included Hepatitis A, B, C, D & E viruses, done by ELISA technique on Strip Reader EIA. The parameters of LFTs evaluated were bilirubin, alanine aminotransferase, alkaline phophatase and albumin. Patients with normal LFTs were not included in this study. Results: Out of these 635 patients, 228 (36%) with abnormal LFTs had Hepatitis A, B, C, D or E positivity. Of these, 153 (67%) were males and 75 (33%) were females. The most common serological finding was of HCV, followed by HBV while a much smaller percentage had HAV, HEV or co-infection with hepatitis viruses. Although most patients belonged to the 20-40 age group, but maximum seropositivity for HCV was found in the 40-60 years age group. 69% of cases with hepatitis had raised ALT, while 31.6% had normal ALT, most having raised ALT being seropositive for HBsAg. One third of the patients had raised levels of serum bilirubin while hypoalbuminemia was a less frequent finding. Conclusion: Liver enzyme levels still remain the most effective method to help in diagnosis and monitoring of liver disease. Based on the observation that 35.9% of patients with abnormal LFTs had viral hepatitis, other causes of abnormal LFTs should be kept in mind in addition to getting viral screening done.

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