Cholangitis laboratory findings

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Farwa Haideri [2]

Overview

Certain laboratory tests may be helpful in the diagnosis of cholangitis. Some commonly conducted tests include complete blood count, basic metabolic panel, liver function tests, blood culture, and other body fluid cultures.

Laboratory Findings

Laboratory findings typically associated with cholangitis include:^[1]^[2]

Cholestatic patterns of liver function tests may be remarkable for:^[1]^[3]^[4]^[5]

Elevated serum alkaline phosphatase (ALP)
Elevated gamma-glutamyl transpeptidase (GGT)
Elevated conjugated (direct) bilirubin (predominantly incase of obstruction)
Elevated serum amylase (7%)
- Levels may be as high as 3-4 times of normal, representing pancreatitis.
Culture from bile obtained during ERCP (endoscopic retrograde cholangiopancreatography)
Elevated aminotransferases (as high as 1000 IU/L), reflecting hepatocytes injury and microabscess formation
- Liver abscess may be suspected in such cases.
Liver enzyme abnormalities suggestive of cholestasis^[2]

Cultures are obtained from bile aspirated through percutaneous biliary catheters, obtained during biliary drainage, or from indwelling biliary prostheses.

References

↑ ^1.0 ^1.1 Liu, Chi-Leung. & Fan, Sheung-Tat. (2001), Surgical Treatment: Evidence-Based and Problem-Oriented., Munich, Germany: Zuckschwerdt Verlag
↑ ^2.0 ^2.1 Cameron, John L. & Cameron, Andrew M. (2014), Current Surgical Therapy: Expert Consult, Philadelphia, PA: Elsevier, Inc.
↑ Andraus W, Haddad L, Nacif LS, Silva FD, Blasbalg R, D’Albuquerque LA (2011). “The best approach for diagnosing primary sclerosing cholangitis”. Clinics (Sao Paulo). 66 (11): 1987–9. PMC 3203975. PMID 22086533.
↑ Björnsson ES, Kilander AF, Olsson RG (2000). “Bile duct bacterial isolates in primary sclerosing cholangitis and certain other forms of cholestasis–a study of bile cultures from ERCP”. Hepatogastroenterology. 47 (36): 1504–8. PMID 11148988.
↑ Wada K, Takada T, Kawarada Y, Nimura Y, Miura F, Yoshida M, Mayumi T, Strasberg S, Pitt HA, Gadacz TR, Büchler MW, Belghiti J, de Santibanes E, Gouma DJ, Neuhaus H, Dervenis C, Fan ST, Chen MF, Ker CG, Bornman PC, Hilvano SC, Kim SW, Liau KH, Kim MH (2007). “Diagnostic criteria and severity assessment of acute cholangitis: Tokyo Guidelines”. J Hepatobiliary Pancreat Surg. 14 (1): 52–8. doi:10.1007/s00534-006-1156-7. PMC 2784515. PMID 17252297.

Overview