Sandeep Barve 1 , Darshana Patel 2 , K. K. Shiromani 3 , Ashish Jawarkar 4
ABSTRACT: BACKGROUND: Liver function tests (LFT) still play a pivotal role in investigating a case of jaundice and hence helps in the diagnosis of a liver disease. In a developing country like India, doctors come across multiple cases of jaundice in day to day practice. Liver functions tests continue to be one of the oldest and basic investigations which a clinician trusts upon to reach the diagnosis of underlying etiology. Liver function tests include liver enzyme studies – SGPT, SGOT, Alkaline phosphatase, GGTP along with S. Bilirubin and S. Protein levels. With the help of liver function tests we can easily assess the cause of jaundice, whether it is due to prehepatic causes, hepatic causes or posthepatic causes. MATERIAL AND METHODS: A study carried out at Parul Institute of Medical Sciences, Vadodara, Gujarat, included 200 patients with jaundice among which were men, women and children of age group – 1 day to 80 years. The study was carried out over a span of 6 months. Liver function tests were performed by collecting samples in plain vacutainer and tests were carried out on Fully Automated Biochemistry Analyzer – SELECTRA BY Merck diagnostics. All the patients had minimum serum total bilirubin levels of greater than 1.5 mg%. RESULTS: Our study included total 200 patients of jaundice with serum bilirubin >1.5 mg%. Among them 55 were females and 145 were males. Patients were of age group 1 day to 80 years. Data revealed that approximately 30% of patients had prehepatic jaundice, 60 % had hepatic type, whereas 10 % had post hepatic type. In pre-hepatic jaundice, liver function tests show increase in indirect bilirubin with minimal or slight increase in the liver enzymes. In hepatic jaundice there is marked elevation in serum enzyme levels principally SGPT and SGOT while slight elevation in alkaline phosphatase and GGTP, elevated serum bilirubin levels is mainly of direct type and serum protein levels were altered. In post hepatic jaundice there is marked elevation in serum direct bilirubin along with marked elevated levels of Serum alkaline phosphatase. CONCLUSION: Liver function tests are used as a primary tool by the clinicians in differential diagnosis of a case of jaundice as they definitely give us a clue to reach to the root cause of jaundice.
