Tutorial presented by Dr Dai Samuel, Consultant Hepatologist, Cwm Taf Morgannwg University Health Board

Liver blood tests are performed regularly, and are frequently found to be abnormal. It’s important not to leave abnormal liver blood tests unchecked, even if the abnormality is only minor; the degree of abnormality, acute or chronic, should be checked. If the repeat liver blood test remains abnormal, there may be an underlying reason for the abnormality and this should be investigated.

Although most patients with abnormal liver blood tests are asymptomatic, symptoms that may point to liver disease including lethargy, malaise and pain in the right upper quadrant.

A history is very important to put the results in the clinical context is very important. Risk factors include:

• Lifestyle factors (alcohol, weight, diabetes, hypertension of high cholesterol)
• Blood borne viruses (travel, high risk sexual contacts, tattoos, blood transfusions and other blood products in the past)
• Drug history including OTC
• Previous liver blood test results to identify a pattern of abnormality