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CONSULT REQUEST GUIDELINES
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Abnormal LFTs
(Hepatitic pattern, AST/ALT >5x upper limit of normal or increased bilirubin)
Suggested Pre-Referral Evaluation and Management Guidelines
1) Test for IgM anti-HAV, HBsAg, IgM anti-HBc, anti-HCV, ANA, Smooth Muscle Antibodies (SMA), SPEP
2) Test for PT/INR
3) Repeat LFT, PT in 1-2 weeks
Suggested Additional Test/Management Prior to Specialty Visit
1) Refer patient
2) Ask for early appointment if AST/ALT >10x upper limit of normal (ULN), bilirubin >2, or INR >1.2
Patient Education/Information (includes preps)
1) American Association for The Study of Liver Diseases
2) Centers for Disease Control & Prevention
3) National Institutes of Health
4) American Liver Foundation
5) Liver Function Panel
Appointment Timeframe 1-2 weeks, call M-LINE and ask to speak to one of the hepatology faculty if urgent appointment is needed
How to Get Results to Consultant UMHS Patients: See CareWeb
External Patients: Hand carry non-UM records, MRI/CT films and biopsy slides to visit unless records sent at least 1 week before clinic visit
Clinic Contact Information Physicians: 800-962-3555 or 800-395-6431
Patients: 800-395-6431
Clinic Location Sites Canton Health Center
Livonia Health Center
GI Clinic Locations
UM Consulting Physician Hepatology Faculty
Revised on: 09/24/2010
 
Abnormal LFTs
(Cholestatic pattern, alkaline phosphatase more markedly elevated than AST/ALT)
Suggested Pre-Referral Evaluation and Management Guidelines
1) RUQ US to rule out biliary obstruction
2) ANA, Anti Mitochondrial Antibodies (AMA) to rule out PBC
Suggested Additional Test/Management Prior to Specialty Visit
1) Refer if bilirubin increased or alk phos >2x upper limit of normal (ULN). Ask for early appointment if patient is overtly jaundiced
2) Repeat LFT if bilirubin normal and alk phos <2x upper limit of normal (ULN), refer if LFT presistently abnormal
Patient Education/Information (includes preps) No treatment other than bed rest is recommended for hepatitis C
1) American Association for The Study of Liver Diseases
2) Centers for Disease Control & Prevention
3) National Institutes of Health
4) American Liver Foundation
5) Liver Function Panel
Appointment Timeframe 1-3 month, call M-LINE and ask to speak to one of the hepatology faculty if urgent appointment is needed
How to Get Results to Consultant UMHS Patients: See CareWeb
External Patients: Fax non-UM records and MRI films to GI Scheduling office
Clinic Contact Information Physicians: 800-962-3555 or 800-395-6431
Patients: 800-395-6431
Clinic Location Sites GI Clinic Locations
UM Consulting Physician Hepatology Faculty
Revised on: 09/24/2010
 
Abnormal LFTs
(Hepatitic pattern, AST/ALT < 5x upper limit of normal, normal bilirubin)
Suggested Pre-Referral Evaluation and Management Guidelines
1) No alcohol
2) Repeat after 2-8 weeks to determine if LFT presistently abnormal
3) Test for HBsAg, anti-HCV
Suggested Additional Test/Management Prior to Specialty Visit
1) Refer if LFT persistently abnormal
2) Test for ANA, Smooth Muscle Antibodies (SMA), Fe/TIBC
3) Test for ceruloplasmin if <40 yr
4) RUQ US to assess for fatty infiltration
Patient Education/Information (includes preps)
1) American Association for The Study of Liver Diseases
2) Centers for Disease Control & Prevention
3) National Institutes of Health
4) American Liver Foundation
5) Liver Function Panel
Appointment Timeframe 1-6 weeks
How to Get Results to Consultant UMHS Patients: See CareWeb
External Patients: Fax non-UM records to GI Scheduling office
Clinic Contact Information Physicians: 800-962-3555 or 800-395-6431
Patients: 800-395-6431
Clinic Location Sites GI Clinic Locations
UM Consulting Physician Hepatology Faculty
Revised on: 09/24/2010
 
 
 

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