Blood test for liver tests in a child

Screening diagnostic tests of the liver in children have their own specifics. The analysis for hepatic tests of the child is aimed at assessing the functional state of the organ. 

The number of studies depends on the appointment of the doctor and the patient's complaints. That is, there is no established diagnostic norm in children. Analyzes are selected based on the age of the baby, its growth and hormonal characteristics, the presence of congenital anomalies and chronic diseases of the body.

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Techniques for conducting

Blood sampling is made from the heel or vein, depending on the age of the small patient.

The norm of liver tests in children

The interpretation of the values of the analysis is not identical to that of adults. Consider the norms of the main hepatic indicators depending on the age of the child:

1. GOLD

This enzyme is analyzed simultaneously with AST, allowing to differentiate violations in the liver and cardiovascular system.

• Children under 6 weeks of 0.37-1.21 mcd / l.
• Up to 12 months - 0,27-0,97 mcd / l.
• Up to 15 years - 0,20-0,63 mkat / l.

The results of many laboratory tests in children differ significantly from the established norms for adults. This refers to the  analysis for hepatic assays. For example, the main marker of bile stasis in adults is a high level of alkaline phosphatase. In children, the activity of this substance is increased, as the body grows. That is, the analysis does not indicate a violation of the hepatobiliary system.

The norm in the results of biochemical liver screening in children:

Age of child	Indicator, mkat / l
	GOLD	It is	GHGP	APF	Bilirubin generic
Up to 6 weeks	0.37-1.21	0.15-0.73	0.37-3.0	1.2-6.3	1st day of life - 0-38 2 nd day of life - 0,85 4th day of life - 0-171 21-day life - 0-29
Up to 12 months	0.27-0.97	0.15-0.85	0.1-1.04	1.44-8.0	0-29
Up to 15 years	0.20-0.63	0.25-0.6	0.1-0.39	1.35-7.5	2.17

 

Blood sampling for analysis is carried out from the heel or ulnar vein. Before the analysis, it is very important that the child does not eat for 8 hours. This is necessary to obtain reliable results. The number of tests for liver tests is prescribed by a doctor. The doctor analyzes the results of the examination of the baby, the presence of complaints and a number of other factors. It also takes into account the presence of congenital anomalies, which, as they mature, return to normal.

Increase and decrease values

Elevated values of alanine aminotransferase are observed in such cases: acute viral hepatitis, cirrhosis, tumor metastases to the liver, leukemia, non-Hodgkin's lymphoma, Reye's syndrome, liver necrosis, hepatitis, toxic organ damage. Alteration of ALT may be associated with diseases of the biliary tract and pancreas, metabolic pathologies, decompensation of heart defects, muscular dystrophy, and body temperature disorders.

2. It is

• Up to 6 weeks 0,15-0,73 mkat / l.
• 6 weeks-12 months - 0,15-0,85 mkat / l.
• Up to 15 years, 0.25-0.6 mcd / l.

An increase in aspartate aminotransferase in the blood of a child is possible in such cases: heart and skeletal muscle diseases, blood diseases. Hepatitis, intoxication, primary hepatoma, cytomegalovirus infection, infectious mononucleosis, acute pancreatitis, hypothyroidism, kidney infarction, decreased potassium level in the blood, Reye syndrome.

3. GHGP

• Children younger than 6 weeks of life - 0.37-3.0 mkat / l.
• Up to 12 months - 0,1-1,04 mcd / l.
• Up to 15 years - 0,1-0,39 mk / l.

Increase in the level of gamma-glutamyltranspeptidase is most often associated with such pathologies: hepatitis, cirrhosis, intoxication, hepatosteatosis, cholestasis, liver metastases, diseases of the cardiovascular system, congenital diseases with increasing levels of fats in the blood, endocrine disorders. Reduction in GGTP levels is observed with hypothyroidism, that is, a decrease in thyroid activity.

4. Alkaline phosphatase

This enzyme is formed in the liver and bones. Adulthood and growth of the child is due to the active production of alkaline phosphatase.

• Newborns up to 6 weeks - 1,2-6,3 mkat / l.
• Children under 1 year of age - 1,44-8,0 mkat / l.
• Children from 2 to 10 years - 1.12-6.2 mkat / l.
• Children from 11 to 15 years old - 1,35-7,5 mkat / l.

The causes of increased AF in children: viral hepatitis, liver abscess, tumor or blockage of the biliary tract, infectious mononucleosis. Diseases of the osseous system, kidneys, leukemia, phosphorus and calcium deficiency, gastrointestinal tract pathologies, chronic diarrhea, nephrotic syndrome. Reduction of AF in patients of childhood is possible in case of severe anemia, hypothyroidism, hypophosphatase, hypoparathyroidism, and also with a lack of growth hormone during puberty.

5. Total bilirubin

• The 1st day of life is 0-38 mcd / l.
• The second day of life is 0.85 mkat / l.
• The 4th day of life is 0-171 mkat / l.
• 21-day life - 0-29 mcd / l.
• Children younger than 1 year - 0-29 mkat / l.
• Children under 15 years of age - 2,17 mkat / l.

A change in bilirubin in the upward direction occurs in such cases: hemolytic jaundice, hepatic jaundice, congenital viral hepatitis, violations of excretion of bile in the liver, blockage of large bile ducts.

In addition to the above indicators, to assess the functional state of the liver in the child may be assigned additional studies: total protein, albumin, creatine kinase, coagulogram, immunological tests and more. Evaluation of indicators of liver samples in children is carried out taking into account a variety of factors, so the interpretation of the results of analysis is the doctor.