Table 2. Initial Laboratory Analysis
Chemistries: sodium, potassium, chloride, bicarbonate, calcium, magnesium, phosphate, glucose, AST, ALT, alkaline phosphatase, GGT, total bilirubin, albumin, creatinine, blood urea nitrogen
Viral hepatitis serologies: anti-HAV IgM, HBsAg, anti-HBc IgM, antiHEVa HCV RNAb
, HSV1 IgM, VZV
Autoimmune markers: ANA, ASMA, immunoglobulin levels Arterial blood gas Arterial lactate
Complete blood count Blood type and screen Acetaminophen level Toxicology screen a If clinically indicated.
Ceruloplasmin levelc Pregnancy test (females)
Ammonia (arterial if possible) HIV-1, HIV-2d
Amylase and lipase Prothrombin time/INR
b Done to recognize potential underlying infection. c
d Implications for potential liver transplantation.
Done only if Wilson disease is a consideration (eg, in patients < 40 years without another obvious explanation for ALF). In this case uric acid level and bilirubin to alkaline phosphatase ratio may be helpful as well.
, anti-HCV,
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