Chronic Hepatitis - Blood Picture
Darsita Jakatia
First Author
Dr Ira Shah
Consultant Pediatrician, B.J.Wadia Hospital for Children, Mumbai, India
First Created: 04/03/2001
Last Updated: 07/24/2025
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Introduction
In chronic hepatitis, a persistent increase in liver enzymes like SGOT, SGPT & GGTP, with normal or marginally elevated bilirubin is seen. Low protein, high globulin, slightly raised cholesterol are characteristic. GGTP is sensitive in detecting chronic hepatitis. Serological tests for detecting hepatitis A & Hepatitis B virus markers are available and are recommended.
| CHEMICAL TESTS
|
NORMAL RANGE
|
PATIENT VALUES
|
| LOW
|
NORMAL
|
HIGH |
| HBDH | 90 -220 IU/L | | * | |
| LDH | 40-110 IU/L | | * | |
| SGOT | 7-24 IU/L | | | * |
| SGPT | 4-25 IU/L | | | * |
| GGTP | 0-31 IU/L | | | * |
| TOTAL BILIRUBIN | 0.2-1.0 mg/dl | | * | |
| CONJ. DIR. BILIRUBIN | 0.1-0.6 mg/dl | | * | |
| UNCONJ. BILIRUBIN | 0.1-0.4 mg/dl | | * | |
| CHOLESTEROL | 125-225 mg/dl | | * | |
| TOTAL PROTEIN | 6-8 Gm/dl | | * | |
| ALBUMIN | 3.5-5.0 Gm/dl | | * | |
| A/G RATIO | 0.9-2.0 | | * | |
| ALK. PHOSPHATASE[1] | A - 44-147 U/L
C - 273.47-871.44 U/L (for 5-8 years) 215.04-893.69 U/L (for 9-13 yrs)
| | * | |
| | A - Adult. C - Child, | | | |
These normal laboratory values may slightly vary from laboratory to laboratory. Please consult your lab for the same.
CHILD PUGH Score- [2]
| Parameter |
1 |
2 |
3 |
| Encephalopathy |
None |
Grade 1 and 2 |
Grade 3 and 4 |
| Ascites |
None |
Slight |
Moderate |
| Bilirubin |
Under 2 mg/ml |
2-3 mg/ml |
Over 3 mg/ml |
| Albumin |
Greater than 3.5 mg/ml |
2.8-3.5 mg/ml |
less than 2.8 mg/ml |
| INR |
less than 1.7 |
1.7-2.2 |
Over 2.2 |
The severity of cirrhosis:
- Child-Pugh A: 5 to 6 points mild disease
- Child-Pugh B: 7 to 9 points moderate disease
- Child-Pugh C: 10 to 15 points severe disease (not suitable for transplant)
PELD (Pediatric End Stage Liver Disease) Score-[3]
The PELD Score is a score that uses several blood parameters like serum albumin, creatinine, bilirubin and INR and is used to identify those patients who are at a higher need for liver transplant (for children below 12 years).
Higher PELD score- more severe liver disease and greater need for liver transplant
1. Gholami Bahnemiri M, Mirabedini S, Mohammadi P, Barmaki H, Qaffaripour Z, Rezapour M, Alijanpour M. Determination of serum alkaline phosphatase reference in healthy children aged 1-18 years. Caspian J Intern Med. 2022 Fall;13(4):749-756. doi: 10.22088/cjim.13.4.749. PMID: 36420337; PMCID: PMC9659844.
2. Tsoris A, Marlar CA. Use Of The Child Pugh Score In Liver Disease. 2023 Mar 13. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan–. PMID: 31194448.
3. https://optn.transplant.hrsa.gov/data/allocation-calculators/peld-calculator/
Darsita Jakatia
Chronic Hepatitis - Blood Picture
https://www.pediatriconcall.com/show_article/default.aspx?main_cat=laboratory-medicine&sub_cat=chronic-hepatitis-blood-picture&url=chronic-hepatitis-blood-picture-introduction
2025-07-24
2025-07-24
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Contributor Information and Disclosures
Darsita Jakatia
First Author
Dr Ira Shah
Consultant Pediatrician, B.J.Wadia Hospital for Children, Mumbai, India
First Created: 04/03/2001
Last Updated: 07/24/2025
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References
1. Gholami Bahnemiri M, Mirabedini S, Mohammadi P, Barmaki H, Qaffaripour Z, Rezapour M, Alijanpour M. Determination of serum alkaline phosphatase reference in healthy children aged 1-18 years. Caspian J Intern Med. 2022 Fall;13(4):749-756. doi: 10.22088/cjim.13.4.749. PMID: 36420337; PMCID: PMC9659844.
2. Tsoris A, Marlar CA. Use Of The Child Pugh Score In Liver Disease. 2023 Mar 13. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan–. PMID: 31194448.
3. https://optn.transplant.hrsa.gov/data/allocation-calculators/peld-calculator/