prothrombin response, serum proteins.

C. Possible Metastatic Cancer

Alkaline phosphatase, transaminases, and bilirubin.

If alkaline phosphatase and transaminases are high in

the presence of normal bilirubin and normal or mildly

increased BSP retention, one should suspect metastatic

cancer in the liver.

Serum protein changes in selected diseases

Disease Albumin Globulin β Globulin γ Globulin

Acute hepatitis N or Sl ↓ N or Sl ↑ Sl ↑ ↑ (IgG and M)

Laennec’s cirrhosis ↓ ↓ N Sl ↑ ↑ ↑ (IgM and A)

Chronic active hepatitis ↓ ↓ N ↑ ↑ ↑ (IgG)

Biliary cirrhosis ↓ ↑ ↑ ↑ ↑ (IgM)

Extrahepatic biliary obstruction N N or Sl ↑ ↑ N

N=normal Sl=slightly, ↓ = moderately depressed, ↓ ↓ = severely depressed, ↑ = moderately elevated, ↑ ↑ = markedly elevated

Liver Function Tests 459

Liver Battery (Profile), Serum

Normal Values are Dependent Upon Methods/Kits/

Manufacturers

Normal values SI units

Alanine Aminotransferase (ALT or SGPT)

Adult female 4–35 U/L

Adult male 7–46 U/L

Children

< 12 months ≤ 54 U/L

Age 1–2 years 3–37 U/L

Age 2–8 years 3–30 U/L

Age 8–16 years 3–38 U/L

Alkaline Phosphatase (ALP)

Adults

Age 20–60 years

Bodansky 2–4 U/dL 10.7–21.5 IU/L

King-Armstrong 4–13 U/dL 25.0–92.3 IU/L

Bessey-LoweryBrock

0.8–2.3 U/dL 13.3–38–3 IU/L

Elderly Slightly Higher

Newborn 1–4 times adult

values

Children Values remain high

until epiphyses close

Female

Age 2–10 years 100–350 U/L

Age 10–13 years 110–400 U/L

Males

Age 2–13 years 100–350 U/L

Age 13–15 years 125–500 U/L

Aspartate Aminotransferase (AST or SGOT)

Adult females

≤ Age 60 years 8–20 U/L 8–20 IU/L

> Age 60 years 10–20 U/L 10–20 IU/L

Adult males

≤ Age 60 8–20 U/L 8–20 IU/L

> Age 60 11–26 U/L 11–26 IU/L

Children

Newborn 16–72 U/L 16–72 IU/L

Infant 15–60 U/L 15–60 IU/L

Age 1 year 16–35 U/L 16–35 IU/L

Age 5 years 19–28 U/L 19–28 IU/L

Bilirubin

1 month–adult < 1.5 mg/dL 1.7–20.5 µmol/L

Premature infant

Cord < 2.8 mg/dL < 48 µmol/L

24 hours 1–6 mg/dL 17–103 µmol/L

48 hours 6–8 mg/dL 103–137 µmol/L

3–5 days 10–12 mg/dL 171–205 µmol/L

Full–term infant

Cord < 2.8 mg/dL < 48 µmol/L

24 hours 2–6 mg/dL 34–103 µmol/L

48 hours 6–7 mg/dL 103–120 µmol/L

3–5 days 4–6 mg/dL 68–103 µmol/L

Gamma–Glutamyl Transferase/Transpeptidase (GGT/GGTP)

Adult female 4–25 U

9–31 mU/mL

3.5–13 IU/L

3–33 U/L at 37°C

Adult males 7–40 U

12–38 mU/mL

4–23 mU/mL

9–69 U/L at 37°C

Children

Cord blood 190–270 U/L at 37°C

Premature infant < 140 U/L at 37°C

1–3 days 56–233 U/L at 37°C

4–21 days 0–130 U/L at 37°C

3–12 weeks 4–120 U/L at 37°C

3–6 months, female 5–35 U/L at 37°C

3–6 months, male 5–5 U/L at 37°C

> 6 months, female 15–85 IU/L

> 6 months, male 5–55 IU/L

1–15 years 0–23 U/L > 37°C

Hepatitis A, B, C, D, E Profile

Negative

Lactate Dehydrogenase (LD/LDH)

Wroblewski method 150–450 U/L 72–217 IU/L

30°C

Adults

< Age 60 45–90 U/L 45–90 U/L

> Age 60 55–102 U/L 55–102 U/L

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460 Concise Book of Medical Laboratory Technology: Methods and Interpretations Children

Newborn 160–500 U/L 160–500 U/L

Neonate 300–1500 U/L 300–1500 U/L

Infant 100–250 U/L 100–250 U/L

Child 60–170 U/L 60–170 U/L

Leucine Aminopeptidase (LAP)

12–33 IU/dL < 50 IU/L

5’Nucleotidase (5’NT or 5’N)

2–15 IU/L

0–17 U/L

0–1.6 U

0.3–3.2 Bodansky units

Protein Electrophoresis

Normals are dependent on laboratory procedure.

Percentage values are for the Agarose method and represent the

percentage of total protein:

Adult (Agarose method)

Total protein 5.90–8.00

Albumin 58–74% 0.58–0.74

Alpha1 globulin 2.0–3.5% 0.02–0.04

Alpha2 globulin 5.4–10.6% 0.05–0.11

Beta globulin 7.0–14.0% 0.07–0.14

Gamma globulin 8.0–18.0% 0.08–0.18

Adult

Total protein 6.0–8.0 g/dL 60–80 g/L

Albumin 3.3–5.0 g/dL 35–50 g/L

Alpha1 globulin 0.1–0.4 g/dL l–4 g/L

Alpha2 globulin 0.5–1 g/dL 5–10 g/L

Beta globulin 0.7–1.2 g/dL 7–12 g/L

Gamma globulin 0.8–1.6 g/dL 8–16 g/L

Premature infant

Total protein 4.4–6.3 g/dL 44–63 g/L

Albumin 3.0–4.2 g/dL 30–42 g/L

Alpha1 globulin 0.11–0.5 g/dL 1.1–5 g/L

Alpha2 globulin 0.3–0.7 g/dL 3–7 g/L

Beta globulin 0.3–1.2 g/dL 3–12 g/L

Gamma globulin 0.3–1.4 g/dL 3–14 g/L

Newborn

Total protein 4.6–7.4 g/dL 46–74 g/L

Albumin 3.5–5.4 g/dL 35–54 g/L

Alpha1 globulin 0.1–0.3 g/dL 1–3 g/L

Alpha2 globulin 0.3–0.5 g/dL 3–5 g/L

Beta globulin 0.2–0.6 g/dL 2–6 g/L

Gamma globulin 0.2–1.2 g/dL 2–12 g/L

Infant

Total protein 6.0–6.7 g/dL 60–67 g/L

Albumin 4.4–5.4 g/dL 44–54 g/L

Alpha1 globulin 0.2–0.4 g/dL 2–4 g/L

Alpha2 globulin 0.5–0.8 g/dL 5–8 g/L

Beta globulin 0.5–0.9 g/dL 5–9 g/L

Gamma globulin 0.3–0.8 g/dL 3–8 g/L

Child

Total protein 6.2–8.0 g/dL 62–80 g/L

Albumin 4.0–5.8 g/dL 40–58 g/L

Alpha1 globulin 0.1–0.4 g/dL 1–4 g/L

Alpha2 globulin 0.4–1.0 g/dL 4–10 g/L

Beta globulin 0.5–1.0 g/dL 5–10 g/L

Gamma globulin 0.3–1.0 g/dL 3–10 g/L

Prothrombin time

Adult 10–15 seconds

Newborn < 17 seconds

Child 11–14 seconds

Usage

Work-up for liver disease, biliary disease, hepatoma, liver

metastatic chronic active hepatitis, cirrhosis, including

biliary cirrhosis, hepatic complications associated with

medications or TPN.

Increased

See individual test listings.

Decreased

See individual test listings.

Description

Liver battery includes testing for several blood levels that

reflect hepatic function. In general, a liver battery includes

the following: Alanine Aminotransferase, Serum; Alkaline

Phosphatase, Serum; Aspartate Aminotransferase, Serum;

Bilirubin. Gamma-Glutamyl Transpeptidase, Blood;

Hepatitis profile Antigen, Blood; Lactate Dehydrogenase.

Blood: Leucine Aminopeptidase, Blood; 5’ Nucleotidase.

Blood: Protein, Electrophoresis, Serum; Prothrombin time,

Blood. See individual test listings for specific descriptions.

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