by Ronnenberg A

Diagnosis of Cirrhosis

The doctor will ask about your symptoms and medical history. A physical exam will be done.
Tests to confirm the diagnosis may include the following:
Blood Tests —there is no blood test to diagnose cirrhosis. Blood tests can only detect signs of liver function problems, such as:
  • Elevated liver enzymes aspartate aminotransaminase (AST), alanine aminotranferase (ALT), alkaline phosphatase, g-glutamyltransferase (GGT) (an indicator of liver damage)
  • Elevated bilirubin (the pigment that produces jaundice and is usually cleared from the body by the liver)
  • Low serum albumin (a protein made by the liver)
  • Blood clotting abnormalities
  • Anemia
  • Ammonia levels
Special tests are ordered to confirm various causative factors including tests for:
  • Viral hepatitis B and C serologies
  • Autoimmune hepatitis with antinuclear antibodies or anti-smooth muscle antibody
  • Hemochromatosis with transferrin saturation, iron-binding capacity, ferritin
  • Wilson disease with serum copper and ceruloplasmin
  • Alpha 1 antitrypsin deficiency with serum alpha 1 antitrypsin plus genetic screening
  • Primary biliary cirrhosis with antimitochondrial antibody
Imaging Tests —These tests help the physician visualize the liver in various ways to determine whether the size and shape are normal or if the liver shows any signs of cirrhosis. Imaging tests may include:
  • CT Scan —a type of x-ray that uses a computer to make pictures of the liver
  • Ultrasound —a test that uses echoes of ultrasound waves to examine internal organs.
  • Liver Scan
  • Abdominal x-ray —a test that uses radiation to take a picture of structures inside the body
  • MRI —test that provides detailed images of internal organs
Laparoscopy —A tube with a tiny video camera mounted on it is inserted through a small incision in the abdomen. It relays pictures back to a computer screen. This also allows the doctor to see the liver and determine whether the size and shape appear normal.
Liver Biopsy —This is the only definite way to diagnose cirrhosis. A needle is used to obtain a small sample of tissue from the liver. The tissue sample is then examined under a microscope to determine whether it shows scarring or other signs of disease.

References

Cirrhosis. American Liver Foundation website. Available at: http://www.liverfoundation.org/abouttheliver/info/cirrhosis . Updated December 3, 2012. Accessed April 24, 2013.

Cirrhosis. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/what.php . Updated December 27, 2012. Accessed April 24, 2013

Cirrhosis. National Institute of Diabetes and Digestive and Kidney Diseases website. Available at: http://digestive.niddk.nih.gov/ddiseases/pubs/cirrhosis/index.aspx . Updated February 21, 2012. Accessed April 24, 2013.

Heidelbaugh JJ, Bruderly M. Cirrhosis and Chronic Liver Failure: Part I. Diagnosis and Evaluation. Am Fam Phys . 2006;74:756-81

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