{"id":5406,"date":"2025-12-08T23:56:32","date_gmt":"2025-12-09T04:56:32","guid":{"rendered":"https:\/\/pressbooks.bccampus.ca\/pathophysiology\/?post_type=chapter&#038;p=5406"},"modified":"2026-05-28T19:25:18","modified_gmt":"2026-05-28T23:25:18","slug":"liver-damage-liver-inflammation-hepatitis-and-liver-enzyme-blood-tests","status":"web-only","type":"chapter","link":"https:\/\/pressbooks.bccampus.ca\/pathophysiology\/chapter\/liver-damage-liver-inflammation-hepatitis-and-liver-enzyme-blood-tests\/","title":{"raw":"10p17  Liver Damage, Liver Inflammation (Hepatitis), and Liver Enzyme Blood Tests","rendered":"10p17  Liver Damage, Liver Inflammation (Hepatitis), and Liver Enzyme Blood Tests"},"content":{"raw":"<h1><strong>Indicators of Liver Damage:<\/strong><\/h1>\r\n[caption id=\"attachment_2284\" align=\"alignnone\" width=\"300\"]<a href=\"https:\/\/pressbooks.bccampus.ca\/pathophysiology\/wp-content\/uploads\/sites\/1961\/2024\/09\/Human_liver_biopsy_sample.jpg\"><img class=\"size-medium wp-image-2284\" src=\"https:\/\/pressbooks.bccampus.ca\/pathophysiology\/wp-content\/uploads\/sites\/1961\/2024\/09\/Human_liver_biopsy_sample-300x193.jpg\" alt=\"Percutaneous liver biopsy collected using a hollow needle inserted between the ribs on the right side, often performed to monitor fatty liver disease, cirrhosis (advance liver damage and scarring), or investigate other unexplained causes of jaundice (symptom of liver dysfunction).\" width=\"300\" height=\"193\" \/><\/a> Percutaneous liver biopsy collected using a hollow needle inserted between the ribs on the right side, often performed to monitor fatty liver disease, cirrhosis (advance liver damage and scarring), or investigate other unexplained causes of jaundice (symptom of liver dysfunction).[\/caption]\r\n<h1><strong>1. Liver Enzymes in Blood<\/strong><\/h1>\r\n<ul>\r\n \t<li><strong>Liver enzymes<\/strong>\u00a0(e.g., ALT, AST) are normally contained within hepatocytes (liver cells).<\/li>\r\n \t<li>When liver cells\u00a0<strong>rupture or die<\/strong>:\r\n<ul>\r\n \t<li>Enzymes leak into the\u00a0<strong>bloodstream<\/strong>.<\/li>\r\n \t<li>Elevated enzyme levels indicate\u00a0<strong>cell damage<\/strong>\u00a0or\u00a0<strong>hepatocyte rupture<\/strong>.<\/li>\r\n<\/ul>\r\n<\/li>\r\n \t<li>Blood tests measuring these enzymes can\u00a0<strong>assess the extent of liver injury<\/strong>.<\/li>\r\n<\/ul>\r\n<h1><strong>2.\u00a0 Impact on Liver Function<\/strong><\/h1>\r\n<ul>\r\n \t<li><strong>Protein synthesis<\/strong>:\r\n<ul>\r\n \t<li>Damaged hepatocytes can't produce normal levels of\u00a0<strong>plasma proteins<\/strong>\u00a0and\u00a0<strong>clotting factors<\/strong>.<\/li>\r\n \t<li>Result:\u00a0<strong>Reduced plasma proteins<\/strong>\u00a0in blood, affecting\u00a0<strong>clotting<\/strong>\u00a0and\u00a0<strong>fluid balance<\/strong>.<\/li>\r\n<\/ul>\r\n<\/li>\r\n \t<li><strong>Bilirubin metabolism<\/strong>:\r\n<ul>\r\n \t<li>Damage causes\u00a0<strong>build-up<\/strong>\u00a0of unconjugated bilirubin in the blood, leading to jaundice.<\/li>\r\n<\/ul>\r\n<\/li>\r\n<\/ul>\r\n&nbsp;\r\n<h1><strong>3.\u00a0 Hepatitis: Inflammation of the Liver<\/strong><\/h1>\r\n<ul>\r\n \t<li><strong>Hepatitis<\/strong>\u00a0literally means\u00a0<strong>liver inflammation<\/strong>.<\/li>\r\n \t<li>Causes:\r\n<ul>\r\n \t<li><strong>Injury or irritation<\/strong>\u00a0(e.g., alcohol, toxins).<\/li>\r\n \t<li><strong>Infections<\/strong>:\u00a0<strong>Hepatitis viruses<\/strong>\u00a0(at least 5 types).<\/li>\r\n \t<li><strong>Idiopathic<\/strong>\u00a0(unknown causes).<\/li>\r\n<\/ul>\r\n<\/li>\r\n<\/ul>\r\n<strong>Pathophysiology<\/strong>\r\n<ul>\r\n \t<li>Severe inflammation damages\u00a0<strong>hepatocytes<\/strong>.<\/li>\r\n \t<li><strong>Structural damage<\/strong>:\r\n<ul>\r\n \t<li>Loss of normal liver architecture.<\/li>\r\n \t<li>Scarring (<strong>fibrosis<\/strong>) and\u00a0<strong>biliary stasis<\/strong>\u00a0(bile flow impairment).<\/li>\r\n \t<li>Bile may\u00a0<strong>back up into the liver<\/strong>, causing further damage.<\/li>\r\n<\/ul>\r\n<\/li>\r\n<\/ul>\r\n<h1><strong>Signs of Liver Damage<\/strong><\/h1>\r\n<ul>\r\n \t<li><strong>Edema<\/strong>\u00a0in inflamed tissues.<\/li>\r\n \t<li><strong>Pain and tenderness<\/strong>\u00a0due to nerve irritation.<\/li>\r\n \t<li><strong>Biliary stasis<\/strong>\u00a0may reduce bile secretion or cause bile duct blockage, exacerbating liver injury.<\/li>\r\n<\/ul>\r\n<h2><strong>Liver Structure &amp; Function<\/strong><\/h2>\r\n<ul>\r\n \t<li>** hepatocytes **:\r\n<ul>\r\n \t<li>Main functional cells.<\/li>\r\n \t<li>Take in\u00a0<strong>blood<\/strong>,\u00a0<strong>screen nutrients<\/strong>.<\/li>\r\n \t<li>Store\u00a0<strong>glucose<\/strong>\u00a0as glycogen,\u00a0<strong>lipids<\/strong>, and\u00a0<strong>amino acids<\/strong>.<\/li>\r\n \t<li>Produce\u00a0<strong>bile<\/strong>\u00a0and send it through\u00a0<strong>bile ducts<\/strong>.<\/li>\r\n<\/ul>\r\n<\/li>\r\n \t<li>Damage to hepatocytes impacts:\r\n<ul>\r\n \t<li>Blood\u00a0<strong>protein<\/strong>\u00a0and\u00a0<strong>clotting factor<\/strong>\u00a0synthesis.<\/li>\r\n \t<li><strong>Bilirubin<\/strong>\u00a0processing.<\/li>\r\n \t<li>Overall\u00a0<strong>metabolic<\/strong>\u00a0processes.<\/li>\r\n<\/ul>\r\n<\/li>\r\n<\/ul>\r\n<h1><strong>Causes of Liver Injury<\/strong><\/h1>\r\n<ul>\r\n \t<li><strong>Alcoholic liver disease<\/strong>.<\/li>\r\n \t<li>Some causes: <strong>idiopathic<\/strong>.<\/li>\r\n \t<li><strong>Viruses<\/strong> (including Hepatitis Virus types A, B, C, D, E):\r\n<ul>\r\n \t<li>Cause viral hepatitis, varying severity.<\/li>\r\n<\/ul>\r\n<\/li>\r\n \t<li><strong>Drugs<\/strong> and <strong>toxins<\/strong><\/li>\r\n \t<li><strong>Reye syndrome<\/strong><\/li>\r\n \t<li>Chronic inflammation can lead to\u00a0<strong>cirrhosis<\/strong>\u00a0and\u00a0<strong>liver failure<\/strong>.<\/li>\r\n<\/ul>\r\n<h1><strong>Summary<\/strong><\/h1>\r\n<ul>\r\n \t<li>Elevated liver enzymes, decreased protein synthesis, and bilirubin build-up signal liver damage.<\/li>\r\n \t<li><strong>Hepatitis<\/strong>\u00a0involves\u00a0<strong>inflammation<\/strong>\u00a0from multiple causes and can vary from mild to severe.<\/li>\r\n \t<li>Protecting the liver involves limiting\u00a0<strong>alcohol<\/strong>, managing\u00a0<strong>viral hepatitis infection<\/strong>, and avoiding toxins.<\/li>\r\n<\/ul>","rendered":"<h1><strong>Indicators of Liver Damage:<\/strong><\/h1>\n<figure id=\"attachment_2284\" aria-describedby=\"caption-attachment-2284\" style=\"width: 300px\" class=\"wp-caption alignnone\"><a href=\"https:\/\/pressbooks.bccampus.ca\/pathophysiology\/wp-content\/uploads\/sites\/1961\/2024\/09\/Human_liver_biopsy_sample.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-2284\" src=\"https:\/\/pressbooks.bccampus.ca\/pathophysiology\/wp-content\/uploads\/sites\/1961\/2024\/09\/Human_liver_biopsy_sample-300x193.jpg\" alt=\"Percutaneous liver biopsy collected using a hollow needle inserted between the ribs on the right side, often performed to monitor fatty liver disease, cirrhosis (advance liver damage and scarring), or investigate other unexplained causes of jaundice (symptom of liver dysfunction).\" width=\"300\" height=\"193\" srcset=\"https:\/\/pressbooks.bccampus.ca\/pathophysiology\/wp-content\/uploads\/sites\/1961\/2024\/09\/Human_liver_biopsy_sample-300x193.jpg 300w, https:\/\/pressbooks.bccampus.ca\/pathophysiology\/wp-content\/uploads\/sites\/1961\/2024\/09\/Human_liver_biopsy_sample-65x42.jpg 65w, https:\/\/pressbooks.bccampus.ca\/pathophysiology\/wp-content\/uploads\/sites\/1961\/2024\/09\/Human_liver_biopsy_sample-225x144.jpg 225w, https:\/\/pressbooks.bccampus.ca\/pathophysiology\/wp-content\/uploads\/sites\/1961\/2024\/09\/Human_liver_biopsy_sample-350x225.jpg 350w, https:\/\/pressbooks.bccampus.ca\/pathophysiology\/wp-content\/uploads\/sites\/1961\/2024\/09\/Human_liver_biopsy_sample.jpg 640w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><\/a><figcaption id=\"caption-attachment-2284\" class=\"wp-caption-text\">Percutaneous liver biopsy collected using a hollow needle inserted between the ribs on the right side, often performed to monitor fatty liver disease, cirrhosis (advance liver damage and scarring), or investigate other unexplained causes of jaundice (symptom of liver dysfunction).<\/figcaption><\/figure>\n<h1><strong>1. Liver Enzymes in Blood<\/strong><\/h1>\n<ul>\n<li><strong>Liver enzymes<\/strong>\u00a0(e.g., ALT, AST) are normally contained within hepatocytes (liver cells).<\/li>\n<li>When liver cells\u00a0<strong>rupture or die<\/strong>:\n<ul>\n<li>Enzymes leak into the\u00a0<strong>bloodstream<\/strong>.<\/li>\n<li>Elevated enzyme levels indicate\u00a0<strong>cell damage<\/strong>\u00a0or\u00a0<strong>hepatocyte rupture<\/strong>.<\/li>\n<\/ul>\n<\/li>\n<li>Blood tests measuring these enzymes can\u00a0<strong>assess the extent of liver injury<\/strong>.<\/li>\n<\/ul>\n<h1><strong>2.\u00a0 Impact on Liver Function<\/strong><\/h1>\n<ul>\n<li><strong>Protein synthesis<\/strong>:\n<ul>\n<li>Damaged hepatocytes can&#8217;t produce normal levels of\u00a0<strong>plasma proteins<\/strong>\u00a0and\u00a0<strong>clotting factors<\/strong>.<\/li>\n<li>Result:\u00a0<strong>Reduced plasma proteins<\/strong>\u00a0in blood, affecting\u00a0<strong>clotting<\/strong>\u00a0and\u00a0<strong>fluid balance<\/strong>.<\/li>\n<\/ul>\n<\/li>\n<li><strong>Bilirubin metabolism<\/strong>:\n<ul>\n<li>Damage causes\u00a0<strong>build-up<\/strong>\u00a0of unconjugated bilirubin in the blood, leading to jaundice.<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<h1><strong>3.\u00a0 Hepatitis: Inflammation of the Liver<\/strong><\/h1>\n<ul>\n<li><strong>Hepatitis<\/strong>\u00a0literally means\u00a0<strong>liver inflammation<\/strong>.<\/li>\n<li>Causes:\n<ul>\n<li><strong>Injury or irritation<\/strong>\u00a0(e.g., alcohol, toxins).<\/li>\n<li><strong>Infections<\/strong>:\u00a0<strong>Hepatitis viruses<\/strong>\u00a0(at least 5 types).<\/li>\n<li><strong>Idiopathic<\/strong>\u00a0(unknown causes).<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<p><strong>Pathophysiology<\/strong><\/p>\n<ul>\n<li>Severe inflammation damages\u00a0<strong>hepatocytes<\/strong>.<\/li>\n<li><strong>Structural damage<\/strong>:\n<ul>\n<li>Loss of normal liver architecture.<\/li>\n<li>Scarring (<strong>fibrosis<\/strong>) and\u00a0<strong>biliary stasis<\/strong>\u00a0(bile flow impairment).<\/li>\n<li>Bile may\u00a0<strong>back up into the liver<\/strong>, causing further damage.<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<h1><strong>Signs of Liver Damage<\/strong><\/h1>\n<ul>\n<li><strong>Edema<\/strong>\u00a0in inflamed tissues.<\/li>\n<li><strong>Pain and tenderness<\/strong>\u00a0due to nerve irritation.<\/li>\n<li><strong>Biliary stasis<\/strong>\u00a0may reduce bile secretion or cause bile duct blockage, exacerbating liver injury.<\/li>\n<\/ul>\n<h2><strong>Liver Structure &amp; Function<\/strong><\/h2>\n<ul>\n<li>** hepatocytes **:\n<ul>\n<li>Main functional cells.<\/li>\n<li>Take in\u00a0<strong>blood<\/strong>,\u00a0<strong>screen nutrients<\/strong>.<\/li>\n<li>Store\u00a0<strong>glucose<\/strong>\u00a0as glycogen,\u00a0<strong>lipids<\/strong>, and\u00a0<strong>amino acids<\/strong>.<\/li>\n<li>Produce\u00a0<strong>bile<\/strong>\u00a0and send it through\u00a0<strong>bile ducts<\/strong>.<\/li>\n<\/ul>\n<\/li>\n<li>Damage to hepatocytes impacts:\n<ul>\n<li>Blood\u00a0<strong>protein<\/strong>\u00a0and\u00a0<strong>clotting factor<\/strong>\u00a0synthesis.<\/li>\n<li><strong>Bilirubin<\/strong>\u00a0processing.<\/li>\n<li>Overall\u00a0<strong>metabolic<\/strong>\u00a0processes.<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<h1><strong>Causes of Liver Injury<\/strong><\/h1>\n<ul>\n<li><strong>Alcoholic liver disease<\/strong>.<\/li>\n<li>Some causes: <strong>idiopathic<\/strong>.<\/li>\n<li><strong>Viruses<\/strong> (including Hepatitis Virus types A, B, C, D, E):\n<ul>\n<li>Cause viral hepatitis, varying severity.<\/li>\n<\/ul>\n<\/li>\n<li><strong>Drugs<\/strong> and <strong>toxins<\/strong><\/li>\n<li><strong>Reye syndrome<\/strong><\/li>\n<li>Chronic inflammation can lead to\u00a0<strong>cirrhosis<\/strong>\u00a0and\u00a0<strong>liver failure<\/strong>.<\/li>\n<\/ul>\n<h1><strong>Summary<\/strong><\/h1>\n<ul>\n<li>Elevated liver enzymes, decreased protein synthesis, and bilirubin build-up signal liver damage.<\/li>\n<li><strong>Hepatitis<\/strong>\u00a0involves\u00a0<strong>inflammation<\/strong>\u00a0from multiple causes and can vary from mild to severe.<\/li>\n<li>Protecting the liver involves limiting\u00a0<strong>alcohol<\/strong>, managing\u00a0<strong>viral hepatitis infection<\/strong>, and avoiding toxins.<\/li>\n<\/ul>\n<div class=\"media-attributions clear\" prefix:cc=\"http:\/\/creativecommons.org\/ns#\" prefix:dc=\"http:\/\/purl.org\/dc\/terms\/\"><h2>Media Attributions<\/h2><ul><li about=\"https:\/\/commons.wikimedia.org\/wiki\/File:Human_liver_biopsy.jpg#\/media\/File:Human_liver_biopsy.jpg\"><a rel=\"cc:attributionURL\" href=\"https:\/\/commons.wikimedia.org\/wiki\/File:Human_liver_biopsy.jpg#\/media\/File:Human_liver_biopsy.jpg\" property=\"dc:title\">Private: Human_liver_biopsy_sample<\/a>  &copy;  NIDDK    is licensed under a  <a rel=\"license\" href=\"https:\/\/creativecommons.org\/publicdomain\/mark\/1.0\/\">Public Domain<\/a> license<\/li><\/ul><\/div>","protected":false},"author":1370,"menu_order":20,"template":"","meta":{"pb_show_title":"on","pb_short_title":"","pb_subtitle":"","pb_authors":["zoe-soon"],"pb_section_license":"cc-by-nc-sa"},"chapter-type":[],"contributor":[60],"license":[57],"class_list":["post-5406","chapter","type-chapter","status-web-only","hentry","contributor-zoe-soon","license-cc-by-nc-sa"],"part":67,"_links":{"self":[{"href":"https:\/\/pressbooks.bccampus.ca\/pathophysiology\/wp-json\/pressbooks\/v2\/chapters\/5406","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/pressbooks.bccampus.ca\/pathophysiology\/wp-json\/pressbooks\/v2\/chapters"}],"about":[{"href":"https:\/\/pressbooks.bccampus.ca\/pathophysiology\/wp-json\/wp\/v2\/types\/chapter"}],"author":[{"embeddable":true,"href":"https:\/\/pressbooks.bccampus.ca\/pathophysiology\/wp-json\/wp\/v2\/users\/1370"}],"version-history":[{"count":7,"href":"https:\/\/pressbooks.bccampus.ca\/pathophysiology\/wp-json\/pressbooks\/v2\/chapters\/5406\/revisions"}],"predecessor-version":[{"id":6401,"href":"https:\/\/pressbooks.bccampus.ca\/pathophysiology\/wp-json\/pressbooks\/v2\/chapters\/5406\/revisions\/6401"}],"part":[{"href":"https:\/\/pressbooks.bccampus.ca\/pathophysiology\/wp-json\/pressbooks\/v2\/parts\/67"}],"metadata":[{"href":"https:\/\/pressbooks.bccampus.ca\/pathophysiology\/wp-json\/pressbooks\/v2\/chapters\/5406\/metadata\/"}],"wp:attachment":[{"href":"https:\/\/pressbooks.bccampus.ca\/pathophysiology\/wp-json\/wp\/v2\/media?parent=5406"}],"wp:term":[{"taxonomy":"chapter-type","embeddable":true,"href":"https:\/\/pressbooks.bccampus.ca\/pathophysiology\/wp-json\/pressbooks\/v2\/chapter-type?post=5406"},{"taxonomy":"contributor","embeddable":true,"href":"https:\/\/pressbooks.bccampus.ca\/pathophysiology\/wp-json\/wp\/v2\/contributor?post=5406"},{"taxonomy":"license","embeddable":true,"href":"https:\/\/pressbooks.bccampus.ca\/pathophysiology\/wp-json\/wp\/v2\/license?post=5406"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}