Patients with abnormal liver blood tests should be categorised into Hepatitic abnormalities and Cholestatic abnormalities, although these patterns are a sliding scale of abnormality.
- Diseases of the liver parenchyma, including viral hepatitis, alcoholic liver disease, non-alcoholic fatty liver disease, metabolic liver diseases
- Increase in the AST and ALT predominantly, more abnormal than the ALP is abnormal
- Diseases of the biliary system or space occupying lesions
- Increase in the ALP above the limits of normal, and more abnormal than the ALT is abnormal
- The GGT is also abnormal
- Combination of the ALP, AST and ALT elevated equally, where neither is predominant but both are elevated abnormally
- This pattern should be investigated as if they are Hepatitic pattern