There is a BSG guideline on the management of abnormal LFT, published in Gut in January, (https://gut.bmj.com/content/67/1/6 ) which states: Recommendation 1: Initial investigation for potential liver disease should include bilirubin, albumin, alanine aminotransferase (ALT), alkaline phosphatase (ALP) and •-glutamyltransferase (GGT), together with a full blood count if not already performed within the previous 12 months. We don’t routinely do GGT, but add it on when we review results and it seems relevant. Regards Marieke Dr Marieke Jordaan Consultant Chemical Pathologist Mid-Yorkshire Trust Email: [log in to unmask] Tel: (01924) 317060 or ext 57060 PA, Diane Blakeston: (01924) 317056 or ext 57056 This e mail or any attachments to it may contain legally privileged or confidential data. You should not forward it to anyone without reference to the Trusts Confidentiality and E Mail policies for guidance. If you are not the intended recipient, please notify the author immediately by telephone or by replying to this e-mail and then delete all copies of the e-mail on your system. If you are not the intended recipient, you must not use, disclose, distribute, copy, print or rely on this e-mail. From: Clinical biochemistry discussion list [mailto:[log in to unmask]] On Behalf Of HOUSTON, Charles (NHS GREATER GLASGOW & CLYDE) Sent: 01 August 2018 12:03 To: [log in to unmask] Subject: Re: LFTs and Osmolality Hi mailbase I would also be interested in knowing What do you include in your LFT profile? Also are there any national guidelines? Our LFTs profile - Total Bilirubin ALT AST ALP Albumin NO total protein – removed about two year ago Would be interested to hear if any labs have deleted AST from their LFT profile , any pros or cons to this. Regards Charlie Charlie Houston MSc CSci FIBMS Laboratory Sector Manager (Specialist / POCT) NHS Greater Glasgow & Clyde ( Glasgow North Sector) Department of Clinical Biochemistry Macewen Building Glasgow Royal Infirmary GLASGOW G4 0SF Glasgow Royal Infirmary - DD 0141 211 5123 [log in to unmask]<mailto:[log in to unmask]> From: Clinical biochemistry discussion list [mailto:[log in to unmask]] On Behalf Of JERINA, Helen (UNIVERSITY HOSPITALS OF LEICESTER NHS TRUST) Sent: 01 August 2018 11:47 To: [log in to unmask] Subject: LFTs and Osmolality Good morning Mailbase, Today I have two questions for you: What do you include in your LFT profile? More specifically, does it include total protein? Do you measure osmolality in both serum and plasma? In my understanding, theoretically, there should be no difference, but we have seen significant positive bias in plasma samples compared with serum in the normal range. Anecdotally I know of a couple of other labs who have found the same and I'd be interested to know the general opinion (if there is one!). As ever, all responses greatly appreciated and I will summarise if I get a few. Best wishes, Helen Helen Jerina PhD Senior Clinical Scientist Department of Chemical Pathology Level 4 Sandringham Building Leicester Royal Infirmary Leicester LE1 5WW ******************************************************************************************************************** This message may contain confidential information. If you are not the intended recipient please inform the sender that you have received the message in error before deleting it. Please do not disclose, copy or distribute information in this e-mail or take any action in relation to its contents. To do so is strictly prohibited and may be unlawful. Thank you for your co-operation. NHSmail is the secure email and directory service available for all NHS staff in England and Scotland. 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If you are not the intended recipient please inform the sender that you have received the message in error before deleting it. Please do not disclose, copy or distribute information in this e-mail or take any action in relation to its contents. To do so is strictly prohibited and may be unlawful. Thank you for your co-operation. NHSmail is the secure email and directory service available for all NHS staff in England and Scotland. NHSmail is approved for exchanging patient data and other sensitive information with NHSmail and other accredited email services. For more information and to find out how you can switch, https://portal.nhs.net/help/joiningnhsmail ------ACB discussion List Information-------- This is an open discussion list for the academic and clinical community working in clinical biochemistry. Please note, archived messages are public and can be viewed via the internet. Views expressed are those of the individual and they are responsible for all message content. ACB Web Site http://www.acb.org.uk Green Laboratories Work http://www.laboratorymedicine.nhs.uk List Archives http://www.jiscmail.ac.uk/lists/ACB-CLIN-CHEM-GEN.html List Instructions (How to leave etc.) http://www.jiscmail.ac.uk/ This email or any attachments to it may contain legally privileged or confidential data. You should not forward it to anyone without reference to the Trusts Confidentiality and EMail policies for guidance. If you are not the intended recipient, please notify the author immediately by telephone or by replying to this e-mail and then delete all copies of the e-mail on your system. If you are not the intended recipient, you must not use, disclose, distribute, copy, print or rely on this e-mail. ------ACB discussion List Information-------- This is an open discussion list for the academic and clinical community working in clinical biochemistry. Please note, archived messages are public and can be viewed via the internet. Views expressed are those of the individual and they are responsible for all message content. ACB Web Site http://www.acb.org.uk Green Laboratories Work http://www.laboratorymedicine.nhs.uk List Archives http://www.jiscmail.ac.uk/lists/ACB-CLIN-CHEM-GEN.html List Instructions (How to leave etc.) http://www.jiscmail.ac.uk/