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Labormedizin pp 91-132 | Cite as

Hepatologische Labordiagnostik

  • Gabriele Halwachs-Baumann
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Die Leber ist ein Organ mit vielfältigen Aufgaben. Demnach gibt es auch eine Reihe von Parametern, die über den Zustand der Leber Auskunft geben können. Grundsätzlich ist zwischen Parametern, die bei einer Lebererkrankung vermehrt im Plasma zu finden sind, und solchen Parametern, die bei einer Lebererkrankung vermindert im Plasma zu finden sind, zu unterscheiden (Tabelle 4.1). Da die Aufgaben der Leber weitreichend in den Stoffwechsel des gesamten Organismus eingreifen, können durch eine Lebererkrankung auch Parameter verändert werden, die auf den ersten Blick nichts mit der Leber zu tun haben. Desgleichen sind die Ursachen für eine Veränderung von Parametern mannigfaltig (Abb. 4.1).

Tabelle 4.1.

Veränderung von Parametern bei Lebererkrankungen

Abb. 4.1.

Ursachen für die Veränderung von Laborparametern durch Lebererkrankungen

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Literatur

Allgemein

  1. Burtis C A, Ashwood E R (eds) (1998) Tietz textbook of clinical chemistry. 3rdedn. WB Saunders, Philadelphia, PAGoogle Scholar
  2. Dufour R D (ed) (2000) Laboratory guidelines for screening, diagnosis and monitoring of hepatic injury. Laboratory medicine practice guidelines of the National Academy of Clinical Biochemistry; Volume 12Google Scholar
  3. Preiser W, Rabenau H F, Doerr H W (2002) Viren —Viruserkrankungen. Zett Verlag, SteinenGoogle Scholar
  4. Thomas L (1998) Labor und Diagnose. TH-Books Verlagsgesellschaft mbH, Frankfurt/MainGoogle Scholar

Speziell

  1. 1.
    Jahrbuch der Gesundheitsstatistik (2002) Herausgeber Statistik AustriaGoogle Scholar
  2. 2.
    Prati D, Taioli E, Zanella A, Della Torre E, Budelli S, Del Vecchio E, Vinello L, Zanuso F, Mozzi F, Dilani S, Conte D, Colombo M, Sirchia G (2002) Updated definitions of healthy ranger for serum alanine aminotransferase levels. Ann Intern Med 137(1): 1–10PubMedGoogle Scholar
  3. 3.
    Novak D, Lewis J H (2003) Drug-induced liver disease. Curr Opin Gastroenterol 19: 203–215PubMedCrossRefGoogle Scholar
  4. 4.
    Ghali P, Lindor K D (2004) Hepatotoxicity of drugs used for treatment of obesity and its comorbidities. Semin Liver Dis 24: 389–397PubMedCrossRefGoogle Scholar
  5. 5.
    Lee W M (2003) Drug-induced hepatotoxicity. N Engl J Med 349(5): 474–485PubMedCrossRefGoogle Scholar
  6. 6.
    Ostapowicz G, Fontana R J, Schiodt F V, Larson A, Davern T J, Han S H B, McCashland T M, Shakil O, Hay J E, Hynan L, Crippin J S, Blei A T, Samuel G, Reisch J, Lee W M, and the US Acute Liver Failure Study Group (2002) Results ofa prospective study of acute liver failure at 17 tertiary care centers in the United States. Ann Intern Med 137: 947–954PubMedGoogle Scholar
  7. 7.
    Schmidt L E, Dalhoff K, Poulsen H E (2002) Acute versus chronic alcohol consumption in acetaminophen-induced hepatotoxicity. Hepatology 35: 876–882PubMedCrossRefGoogle Scholar
  8. 8.
    Schmidt L E, Dalhoff K (2002) Serum phosphate is an early predictor of outcome in severe acetaminophen-induced hepatotoxicity. Hepatology 36: 659–665PubMedCrossRefGoogle Scholar
  9. 9.
    Schmidt L E, Dalhoff K (2005) Alpha-fetoprotein is a predictor of outcome in acetaminophen-induced liver injury. Hepatology 41: 26–31PubMedCrossRefGoogle Scholar
  10. 10.
    Bernal W, Donaldson N, Wyncoll D, Wendon J (2002) Blood lactate as an early predictor of outcome in paracetamol-induced acute liver failure: a cohort study. Lancet 359: 558–563PubMedCrossRefGoogle Scholar
  11. 11.
    Rumack B H, Matthew H (1975) Acetaminophen poisoning and toxicity. Pediatirics 55(6): 871–876Google Scholar
  12. 12.
    Rumack B H (1999) Acetaminophen overdose? A quick answer. J Pediatr 135(3): 269–270PubMedCrossRefGoogle Scholar
  13. 13.
    Anderson B J, Holford N H, Armishaw J C, Aicken R (1999) Predicting concentrations in children presenting with acetaminophen overdose. J Pediatr 135(3): 290–295PubMedCrossRefGoogle Scholar
  14. 14.
    Hoeksema H L, Bock G H (1993) The value of laboratory tests for the screening and recognition of alcohol abuse in primary care patients. J Fam Pract 37: 268–276PubMedGoogle Scholar
  15. 15.
    Levitsky J, Mailliard M E (2004) Diagnosis and therapy of alcoholic liver disease. Semin Liver Dis 24(3): 233–247PubMedCrossRefGoogle Scholar
  16. 16.
    Skinner H A, Holt S, Schuller R, Roy J, Israel Y (1984) Identification of alcohol abuse using laboratory tests and a history of trauma. Ann Int Med 101: 847–851PubMedGoogle Scholar
  17. 17.
    Sorbi D, Boynton J, Lindor K D (1999) The ratio of aspartate aminotransferase to alanine aminotransferase: Potential value in differentiating nonalcoholic steatohepatitis from alcoholic liver disease. Am J Gastroenterol 94: 1018–1022PubMedCrossRefGoogle Scholar
  18. 18.
    Ludwig S, Kaplowitz N (1980) Effect of pyridoxine deficiency on serum and liver transaminase in experimental liver injury in the rat. Gastroenterology 79(3): 545–549PubMedGoogle Scholar
  19. 19.
    Ballard H (1997) The hematological complications of alcoholism. Alcohol Health Research World 21(1): 42–52Google Scholar
  20. 20.
    Flahaut C, Michalski J C, Danel T, Humbert M H, Klein A (2003) The effects of ethanol on the glycoxylation of human transferrin. Glycobiology 13(3): 191–198PubMedCrossRefGoogle Scholar
  21. 21.
    Fleming M F, Anton R F, Spies C D (2004) A review of genetic, biological, pharmacological, and clinical factors that affect carbohydrate-deficient transferrin levels. Alcohol Clin Exp Res 28(9): 1347–1355PubMedCrossRefGoogle Scholar
  22. 22.
    Stauber R E, Vollmann H, Pesserl, Jauk B, Lipp R, Halwachs G, Wilders-Truschnig M (1996) Carbohydrate-deficient transferrin in healthy women: relation to estrogens and iron status. Alcohol. Clin Exp Res 20: 1114–1117PubMedCrossRefGoogle Scholar
  23. 23.
    Koch H, Meerkerk J J, Zaat J O, Ham M F, Scholten R J, Assendelft W J (2004) Accuracy of carbohydrate-deficient transferrin in the detection of excessive alcohol consumption: a systematic review. Alcohol Alcohol 39(2): 75–85PubMedGoogle Scholar
  24. 24.
    Schwan R, Albuisson E, Malet L, Loiseaux M N, Reynaud M, Schellenberg F, Brousse G, Llorca P M (2004) The use of biological laboratory markers in the diagnosis of alcohol misuse: an evidence-based approach. Drug Alcohol Depend 74(3): 273–279PubMedCrossRefGoogle Scholar
  25. 25.
    Ferenci P (2004) Review article: diagnosis and current therapy of Wilsons’s disease. Aliment Pharmacol Ther 19: 157–165PubMedCrossRefGoogle Scholar
  26. 26.
    Yuce A, Kocak N, Demir H, Gurakan F, Ozen H, Saltik I N, Ozcay F (2003) Evaluation of diagnostic parameters of Wilsons’s disease in childhood. Indian J Gastroenterol 22(1): 4–6PubMedGoogle Scholar
  27. 27.
    Pietrangelo A (2004) Hereditary hemochromatosis — a new look at an old disease. N Engl J Med 350(23): 2383–2397PubMedCrossRefGoogle Scholar
  28. 28.
    Limdi J K, Crampton J R (2004) Hereditary haemochromatosis. Q J Med 97: 315–324Google Scholar
  29. 29.
    Child III C G, Turcotte J G (1964) Surgery and portal hypertension. In: Child III C G (ed) The liver and portal hypertension. Saunders, Philadelphia, 50Google Scholar
  30. 30.
    Pugh R N, Murray-Lyon I M, Dawson J L (1973) Transection of the oesophagus for bleeding oesophageal varices. Br J Surg 122: 646–649CrossRefGoogle Scholar
  31. 31.
    Knaus W A, Wagner D P, Draper E A, Zimmerman J E, Bergner M, Bastos P G, Sirio C A, Murphy D J, Lotring T, Damiano A (1991) The APACHE III prognostic system. Risk predicition of hospital mortality for critically ill hospitalized adults. Chest 100: 1619–1636PubMedCrossRefGoogle Scholar
  32. 32.
    Wiesner R, Edwards E, Freeman R, Harper A, Kim R, Kamath P, Kremers W, Lake J, Howard T, Merion R M, Wolfe R A, Krom R, and the United Network for Organ Sharing Liver Disease Severity Score Committee (2003) Gastroenterology 124: 91–96PubMedCrossRefGoogle Scholar
  33. 33.
    Pol S, Nalpas B, Vassault A, Bousquet-Lemercier B, Franco D, Lacour B, Berthelot P, Nanoune J, Barouki R (1991) Hepatic activity and mRNA expression of aspartate aminotransferase isoenzymes in alcoholic and nonalcoholic liver disease. Hepatology 14: 620–625PubMedGoogle Scholar
  34. 34.
    Nalpas B, Vassault A, Charpin S, Lacour B, Berthelot P (1986) Serum mitochondrial aspartate aminotransferase as a merker of chronic alcoholism: diagnostic value and interpretation in a liver unit. Hepatology 6(4): 608–614PubMedCrossRefGoogle Scholar
  35. 35.
    Zhou S L, Gordon R E, Bradbury M, Stump D, Kiang C L, Berk P D (1998) Ethanol up-regulates faty acid uptake and plasma membrane expression and export of mitochondrial aspartate aminotransferase in HepG2 cells. Hepatology 27(4): 1064–1074PubMedCrossRefGoogle Scholar

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© Springer-Verlag/Wien 2011

Authors and Affiliations

  • Gabriele Halwachs-Baumann
    • 1
  1. 1.Institut für Medizinische und Chemische Labordiagnostik, Krankenhaus SteyrSteyrÖsterreich

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