The Laboratory Diagnosis of Liver Disease

The liver has more varied functions than perhaps any other organ in the body. The hepatic parenchymal cells are involved in protein synthesis (almost all plasma/serum proteins including blood coagulation factors; immunoglobulins are not made in the liver but are made by plasma cells in the bone marrow), lipid metabolism (fat, cholesterol, phospholipids, lipoproteins), carbohydrate metabolism (gluconeogenesis, glycogenolysis), storage functions (most vitamins, iron, copper, trace metals), excretory functions (bilirubin, bile salts), and detoxification (ammonia, steroids, drugs, poisons) Marzinke and Dufour, Laboratory diagnosis of liver Disease. In: Clarke W, Marzinke MA (eds) Contemporary practice in clinical chemistry, 4th edn. Academic Press, London, pp 545–59. ISBN 978-0128154991, 2020; Bethea and Pratt, Evaluation of liver function. In: Loscalzo J, Fauci A, Kasper DL, Longo D, Hauser SL, Jameson JL (eds) Harrison’s principles of internal medicine, 21st edn. McGraw Hill, New York. https://accessmedicine.mhmedical.com/content.aspx?bookid=3095§ionid=264532446. Accessed 16 Apr 2024, 2022. Liver disease may be confined to the organ itself (e.g., cirrhosis, infection, neoplasms) or can be secondary to systemic disease (e.g., congestive heart failure, hemochromatosis). A basic understanding of laboratory testing of liver function is important in the diagnostic workup of liver disease.