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Alkaline phosphatase (ALP)
Obstructive hepatobiliary disease, HCC, bone disease
Aminotransferases (AST and ALT) (often called liver enzymes)
Viral hepatitis (ALT>AST)
Alcoholic hepatitis (AST>ALT)
Amylase
Acute pancreatitis, mumps
Ceruloplasmin
Decreased in Wilson's disease
GGT (gamma-glutamyl transpeptidase)
Increased in various liver and biliary diseases but NOT in bone disease. Associated with alcohol use.
Lipase
Acute pancreatitis (most specific)
Common, benign liver tumor; typically at 30-50 years. Biopsy contraindicated because of risk of hemorrhage.
Cavernous hemangioma
Rare, benign liver tumor, often related to oral contraceptives or anabolic steroid use; may regress spontaneously or rupture (abdominal pain and shock)
Hepatic adenoma
Malignant tumor of endothelial origin; associated with exposure to arsenic, vinyl chloride.
Angiosarcoma
Due to backup of blood into liver. Common caused by right sided heart failure and Budd-Chiari syndrome. The liver appears mottled like nutmeg. If the condition persists, centrilobular congestion and necrosis can result in cardiac cirrhosis.
Nutmeg liver
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