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, antinuclear antibody (ANA), smooth muscle antibodies(SMA), SPEP
2) Test for serum protein electrophoresis(SPEP)
3) Test for PT/INR
4) 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 and 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: Send through MiChart patient portal
External Patients: Fax to Hepatology office at 734-998-1453 or hand carry non-UM records if timing does not allow, Hand carry MRI/CT CD and biopsy slides to visit
Clinic Contact Information Physicians: 800-962-3555 or 844-233-0433
Patients: 844-233-0433
Clinic Location Sites Hepatology Clinic Locations
UM Consulting Physician Hepatology Faculty
Revised on: 12/18/2015
 
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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, antimitochondrial antibodies (AMA) to rule out PBC
3) PT/INR if bilirubin is increased
Suggested Additional Test/Management Prior to Specialty Visit
1) Refer if bilirubin increased or alkaline phosphatase >2x upper limit of normal (ULN). Ask for early appointment if patient is overtly jaundiced
2) Repeat LFT if bilirubin normal and alkaline phosphatase <2x upper limit of normal (ULN), refer if LFT persistently abnormal
Patient Education/Information (includes preps)
1) American Association for the Study of Liver Diseases
2) Centers for Disease Control and 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: Send through MiChart Patient portal
External Patients: Fax non-UM records to Hepatology office 734-998-1453. Ask patient to hand carry CD of CT or MRI to clinic.
Clinic Contact Information Physicians: 800-962-3555 or 844-233-0433
Patients: 844-233-0433
Clinic Location Sites Hepatology Clinic Locations
UM Consulting Physician Hepatology Faculty
Revised on: 12/18/2015
 
Print
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 persistently abnormal
3) Test for HBsAg, anti-HCV
Suggested Additional Test/Management Prior to Specialty Visit
1) Refer if LFT persistently abnormal
2) Test for antinuclear antibody (ANA), smooth muscle antibodies (SMA), ferritin/total iron-binding capacity (Fe/TIBC)
3) Test for ceruloplasmin if patient younger than 40 years
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 and 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: Send through MiChart patient portal
External Patients: Fax non-UM records to Hepatology Office 734-998-1453
Clinic Contact Information Physicians: 800-962-3555 or 844-233-0433
Patients: 844-233-0433
Clinic Location Sites Hepatology Clinic Locations
UM Consulting Physician Hepatology Faculty
Revised on: 12/18/2015
 
 
 

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