Editing Liver function tests (section)

== Other tests ==
Other tests are requested alongside LFT to rule out specific causes.

===5' Nucleotidase===
{| class="wikitable" align="right"
| Reference range
|-
| 0 to 15 IU/L<ref name="Shivaraj 2009"/>
|}

5' [[Nucleotidase]] (5NT) is a [[glycoprotein]] found throughout the body, in the cytoplasmic membrane, catalyzing the conversion to inorganic phosphates from nucleoside-5-phosphate. Its level is raised in conditions such as obstructive jaundice, parenchymal liver disease, liver metastases, and bone disease.<ref name="Shivaraj 2009"/>

Serum NT levels are higher during 2nd and 3rd trimesters in pregnancy.<ref name="Shivaraj 2009"/>

===Ceruloplasmin===
{| class="wikitable" align="right"
| Reference range
|-
| 200–600&nbsp;mg/L<ref name="Shivaraj 2009"/>
|}
{{Main|Ceruloplasmin}}
Ceruloplasmin is an [[acute phase protein]] synthesized in the liver. It is the carrier of the copper ion. Its level is increased in infections, [[rheumatoid arthritis]], pregnancy, non-Wilson liver disease and obstructive jaundice. In Wilson disease, the ceruloplasmin level is depressed which lead to copper accumulation in body tissues.<ref name="Shivaraj 2009"/>

===Alpha-fetoprotein===
{| class="wikitable" align="right"
| Reference range
|-
|0-15 μg/L<ref name="Shivaraj 2009"/>
|}
{{Main|Alpha-fetoprotein}}
Alpha-fetoprotein (AFP) is significantly expressed in foetal liver. However, the mechanism that led to the suppression of AFP synthesis in adults is not fully known. Exposure of the liver to cancer-causing agents and arrest of liver maturation in childhood can lead to the rise in AFP. AFP can reach until 400–500 μg/L in [[hepatocellular carcinoma]]. AFP concentration of more than 400 μg/L is associated with greater tumour size, involvement of both lobes of liver, portal vein invasion and a lower median survival rate.<ref name="Shivaraj 2009"/>

===Coagulation test===
The liver is responsible for the production of the vast majority of [[coagulation]] factors. In patients with liver disease, [[international normalized ratio]] (INR) can be used as a marker of liver synthetic function as it includes [[factor VII]], which has the shortest half life (2–6 hours) of all coagulation factors measured in INR. An elevated INR in patients with liver disease, however, does not necessarily mean the patient has a tendency to bleed, as it only measures procoagulants and not anticoagulants. In liver disease the synthesis of both are decreased and some patients are even found to be hypercoagulable (increased tendency to clot) despite an elevated INR. In liver patients, coagulation is better determined by more modern tests such as [[thromboelastogram]] (TEG) or thomboelastrometry (ROTEM).{{citation needed|date=November 2021}}

Prothrombin time (PT) and its derived measures of prothrombin ratio (PR) and INR are measures of the [[Coagulation#Tissue factor pathway (extrinsic)|extrinsic pathway]] of [[coagulation]]. This test is also called "ProTime INR" and "INR PT". They are used to determine the clotting tendency of blood, in the measure of [[warfarin]] dosage, liver damage, and [[vitamin K]] status.<ref>{{Cite web|title=Prothrombin Time Test and INR (PT/INR): MedlinePlus Medical Test|url=https://medlineplus.gov/lab-tests/prothrombin-time-test-and-inr-ptinr/|access-date=2021-02-25|website=medlineplus.gov|language=en}}</ref>

===Serum glucose===
The serum glucose test, abbreviated as "BG" or "Glu", measures the liver's ability to produce glucose ([[gluconeogenesis]]); it is usually the last function to be lost in the setting of [[fulminant liver failure]].<ref>{{Cite web|url=https://www.letsgetchecked.com/articles/how-often-should-you-get-liver-function-check/|title=Liver Function Test: How Often Should you Check Your Liver Function?|first=Hannah|last=Kingston|website=LetsGetChecked}}</ref>

===Lactate dehydrogenase===
[[Lactate dehydrogenase]] (LDH) is found in many body tissues, including the liver. Elevated levels of LDH may indicate liver damage.<ref>{{Cite web|title=Lactate Dehydrogenase (LDH) Test: MedlinePlus Medical Test|url=https://medlineplus.gov/lab-tests/lactate-dehydrogenase-ldh-test/|access-date=2021-02-25|website=medlineplus.gov|language=en}}</ref> LDH isotype-1 (or cardiac) is used for estimating damage to cardiac tissue, although troponin and creatine kinase tests are preferred.<ref>{{cite journal |vauthors=Nageh T, Sherwood RA, Harris BM, Byrne JA, Thomas MR | title = Cardiac troponin T and I and creatine kinase-MB as markers of myocardial injury and predictors of outcome following percutaneous coronary intervention | journal = International Journal of Cardiology | volume = 92 | issue = 2–3 | pages = 285–293 | year = 2003 | pmid = 14659867 | doi = 10.1016/S0167-5273(03)00105-0 }}</ref>